Adding Booking form to current site.

An online booking in system. ## Deliverables Using clients current site template add a booking form where customers can do the following: Enter name: Address: Phone Number: Email Address: Console Make / Model Brief Description of Problem or use the quick select options below (Text box where they can enter a description) or tick one of the boxes below: Gerneral: Reballing Required No Power: Repair DVD/BlueRay Console Very Noisy Carry out other repair/Mod Xbox 360: RROD 1 Red Light 2 Red Lights 3 Red Lights 4 Red Lights 2nd Error Code: **** PS3 YLOD Console Very Noisy Carry out other repair/Mod If xbox 360 2nd Error code (little question mark when they put mouse over it pops up with details on how to obtain the code) Console Serial Number: Once they hit submit the data is entered into a database with a ref number and an email is fired off which they need to confirm with a radom unique link like you have to do with forum reg it should also have the anti spam system used on the contact form currently used. Once link is confirmed and they are a real person a 2nd email will be sent to them with a shipping address label they can either print out or save, prob best to make .PDF (example) TO: Companies Address REF: ***************** From: Customers House Number: Post Code: (example: 27 1AA 2FA) So once the unit arrives for repair it can be found nice and easy with a quick search option for admins, admins need a basic login username / password to check data. ********************************************************* Please dont post standard templates as your bid / offer will be hidden I am looking for someone who can read the above and ask questions to this project before accepting for the job.