Basic Feedback page

I have constructed two basic html pages, which you can see attached. The pages contains a few text boxes, checkboxes, which when filled in by the user will send to the Mysql database that I have already set up on a server, but the tables are not constructed, this will be up to the bidder on what fields will be needed, I have phpmyadmin connected to the database, so it will be very easy to create a table or tables, for the fields. The first page titled “First Prototype [login to view URL]? The user will fill in his name and email, then when the Next button the information is sent to the database, and the page titled “Feed Back Page?? is called, with the Full Name textfield, and the E-mail textfields filled in, for the previous page information. When the “Feed Back Page?? is filled in the user will press send and the information is sent to the database. An example of what the table in the database might look like is attached in a excel file. This example is just one possible route to take. Also, I would like the code for the inserting of information into the database to be PHP. ## 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 Web page in Internet Explorer 6, web page connecting to the Mysql database I have set up.