Hi,
I Just had a look at your project, it seems that you need a web developer who can convert your form in html form and i hope there is also need of some php script which can be use to store those data into the database.
Here is my small introduction, my name is Sudhakar Kumar and i have experienced in web development using latest technology like HTML5, CSS3, Javascript, jquery,bootstrap,php and mysql.
It would be great if we could have a little discussion about your project before awarding it to anyone.
your decision will be appreciated under any circumstances.
Regards
Sudhakar Kumar