DEAR MANAGER,
After reading your job description details and reviewing the attached form, i can create the form using web technology and host it on a free hosting with a dynamic database and a simple reports panel for your administration/ management.
I have 8 years experience in developing web portals and websites so I can help you in all aspects to finish the job in efficient way, i can provide you with an examples for my recent works.
Looking to talk with you ASAP.
Best regards,
Mohammed