Build Data Entry App

Simple straightforward app to collect specific information and forward the results via email to an email address. Create mobile app to collect specific information. Once collected, user should be able then click a single "Submit" button to send the data to the specified email addresses. The sender should be able to receive a notification or an acknowledgement of the data having been received/read by either one of the two email addresses, if easily possible. App admin should be able to input, change email address as needed. Information: Name (Firstname, Lastname) required Address: required Phone number: required Date of Birth: required Email Address: Optional Marital Status: required Driver's License number: required VIN: Optional Current Policy: Yes or No (radio button) Declaration page: Yes or No (radio button) Household residents 15 years and older: Yes or No (radio button) Submit button The app should indicate the data has been successfully submitted.