Creating form for html and perl.

Write a www page ([login to view URL]) which uses one Perl CGI program ([login to view URL]) to allow students to submit their personal information through a form, the student’s information should contains student number, student name, address, and telephone number etc. On submission, two main actions will take place, first the student’s information will add onto a database file called [login to view URL], second, an email should be sent to you. When both actions are successful, it displays a successful page to confirm that student has submitted it successfully! If any of the two actions failed, it displays an error page indicating which action is failed! [login to view URL] also contains another CGI ([login to view URL]) program to open file [login to view URL] and list its full content in a table format. Finally, all the html programs should be uploaded to your Linux account, in a folder called .public_html, and the CGI programs should be in the cgi-bin subfolder, so that your program can be accessed through Internet by using a web browser! . need this done by 12 hours and i want it to be very simple as possible i will show a file on how i want it look