ADSL Application form

i need an application form in 2 formats 1 in pdf and the other one in publisher or word document. Its for customers who want to join broadband adsl service so i will give the winning coder access to the website which has around 20-30 different adsl plans that needs to be added in the form as well as the contract options, customer details etc.. it needs to be 1-2 pages long please only bid if you understand the project if not, plz contact me for more details before bidding. I need this completed in in 3 days ## Deliverables 1) Complete and fully-functional working program(s) in executable form as well as complete source code of all work done. 2) Deliverables must be in ready-to-run condition, as follows (depending on the nature of the deliverables): a) For web sites or other server-side deliverables intended to only ever exist in one place in the Buyer's environment--Deliverables must be installed by the Seller in ready-to-run condition in the Buyer's environment. b) For all others including desktop software or software the buyer intends to distribute: A software installation package that will install the software in ready-to-run condition on the platform(s) specified in this bid request. 3) All deliverables will be considered "work made for hire" under U.S. Copyright law. Buyer will receive exclusive and complete copyrights to all work purchased. (No GPL, GNU, 3rd party components, etc. unless all copyright ramifications are explained AND AGREED TO by the buyer on the site per the coder's Seller Legal Agreement). ## Platform adobe pdf, publisher, excel or word