Create HTML Form and PHP MYSQL Database (must complete in 10 hours)(Ron A)

We have a functional web site. We need for you to create a form on our main page. This form will write to a MYSQL database using PHP The database will have 1 table and up to 15 fields. We need a separate UI access to this database with a login ID and password. We need the ability to query each field. We need to have the ability to dump the query results and the entire database to a CSV spreadsheet from the UI. Our Host is Godaddy on Linux... Deliverables: 1 form and 1 database which can be queried via a UI and the results dumped to a CSV file.