Create a Wordpress Template

We are a mortgage broker company who need to convert our PDF mortgage application form to a WordPress plugin. There's a total of 10 pages in the PDF, with quite a lot of fields of information required. You should be able to design the form in a nice user friendly way. The resulting submission should be converted back to a completed PDF file and emailed to us. The PDF doesn't have to be exactly the same format as our current application, but should follow the same basic criteria and layout.