226912 Quote Forum

Hello, My friend that is a programmer said this wouldn't be to much money to have made. It's fairly Easy. I need it to be php or html doesnt matter. I need the background to have the color I want, same with the tables and the table borders, along with the text color inside the tables ect ect. I need it to be very basic and directed to my email when the user hits send. Here is what I need it to do. [B]+++++++++++++++++++++++++++++++++++[/B] Random Text up top that I can edit here.. lalala. [B]First Name:[/B] [text box] [B]Last Name:[/B] [text box] (space) [B]Company Name:[/B] [text box] (space) [B]Phone Number:[/B] [text box] (space) [B]Email:[/B] [text box] Confirm Email: [text box] (space) [B]Current Website:[/B] [text box] (space) [B]What does your Web project entail?[/B] [Radio Buttons] + Build a New Web Site + Rebuild an Existing Web Site + Updates or Maintenance of an Existing Web Site (space) [B]Please describe your project:[/B] (i wanna add something right here) (big text box allow 1,000 characters) (space) [B]Which option best describes your Web Design needs?[/B] [Radio Buttons] + General Web Design + Healthcare Web Design + eCommerce Web Design + Real Estate Web Design + Other [B]What types of features will your Web Site require?[/B] (check all that apply) [this will also be radio buttons] + Auction + Dynamic or Updateable Content + Blog + Flash/Multimedia + Catalog and Shopping Cart + Membership/Social Networking/Dating + Customer Login + Adult + Discussion Forums + Gambling + Donations [B]Estimated pages needed, including home page:[/B] (radio buttons) + 1 - 5 pages + 6 - 10 pages + 11- 20 pages + 21+ +Ecommerce Site with multiple pages [B]What additional services will you need?[/B] (check all that apply) (radio buttons aswell) + 3D Animation + Audio Producing + Business Cards + Printing + Graphic Design + Web Hosting + Video Production + Gaming Production + Online Game Filming + Online Marketing + Paypal + Logo Design + Other. [B]If you selected other please explain here: [/B] (text box allow 400 characters) [B]Project Budget :[/B] (radio buttons) $250 - 500 (Small Budget? Try a website builder)-that should link to geocities $501 - 1000 $1001 - 1500 $1501 -2000 $2001 + [B]How soon would you like to start this project:[/B] (radio buttons) + As Soon as Possible + 1-4 Days + 1 week + 1-3 weeks + A while. [B]When is your deadline:[/B] (text box) [B] SUBMIT REST [/B] [B]Thank you for filling out this request sheet, we will get back with you with a quote, we are sorry for such a long request form, however, the most details we can get from you the best accurate quote we can get you. [/B] ++++++++++++++++++++++++++++++++++++++++++++++++ Thanks!