Checklist needed for websites

I am in need of a checklist that I can put on my photography websites. It would be about 50-60 questions and some would need to have "check all that apply" ability to them. You can sort of get an idea of what I am seeking by looking at [login to view URL] I want something like that but want some of what is on that form removed and other questions added and the colors used to be different, as well as the layout. I also need this to be set up as a data base so I can save the information the models send to me. I want this to be able to work on multiple photography sites I have and have it coded so that when the model is finished her answers are emailed to me. If you need more specifics please contact me ASAP ## 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 I would prefer this checklist work in all browsers possible.