Wp Plugin To Create Survey Page

I need a plugin created that will launch a survey page on any WordPress site. Once installed on a WordPress site, the plugin will launch a survey page on the site, and the user will be able to customize the survey page.

Here are the details:

– The plugin will contain text that will be automatically included in every survey page that is launched. The plugin will also automatically include the following footer elements: Home, About, Contact Us, Links.

– In the plugin “settings”, the user will be able to input some information to customize the content on the survey page. This is the information they will be able to customize:

* name of the web page (e.g. http://www.MySite.com/NameOfPage)
* headline of the survey
* text that will go into specified fields on the page
* form code for the survey (i.e. the code that is provided by the online survey company)
* URL for the location of an image (there will be one image on the survey page)
* signature at the bottom of the content (e.g. John Smith, Ph.D.)
* URLs for links at the bottom of the survey page

I have attached a screenshot of the survey page that I would like the plugin to generate. On the screenshot, I have highlighted (in yellow) the fields that need to be customizable in the plugin “settings” page. (I have labelled each separate field with an “F”; so “F1” is field 1; “F2” is field 2; etc.)

If bidders have any questions, please PM me.

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