Need a form to be made. I have tried to explain it roughly in attached [url removed, login to view] file. Please read and PM me any questions you may have.
Max. Budget 75 USD
You can suggest other methods of achieving the same result. It's about visitors able to fill this form on my website and me being able to access/edit it. Nothing fancy required, just functionality.
Hosting info: php, mysql support and anything else without problem.