Online Registration Form (simple)

I have a simple job. I need an online registration form completed I have the example of the form in pdf I need it converted to html with a css style sheet attach to update in the future.

I want it very neat and clean not like the attached example. I want someone who can work fast in efficient need this done before friday.

I will also need it linked to our database for results or emailed in a simple easy to read form.

I have a word press blog style website for a major entertainment company. this bidder must be discreet and willing to sign confidentiality agreement no exceptions.

Happy bidding

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