Loan Application form to printable HTML document(repost)

This project is for a loan application form (outlined below). The data from the form must be appended to an html document ([login to view URL]) which will be printed at the end of the night. A template for the formatted html document will be provided so all you need to is provide the php code. Requirements: **User form** 1) If an applicant leaves any field empty, they receive an error. 2) Applications are appended to html document If any further clarification is needed, please ask. **Application Form Guideline** How much would you like to borrow? £ ___ (must be between 1000 and 15000) Over how many months would you like to repay the loan? ___ (must be between 12 and 60 months) Purpose of Loan ___ First Name(s) ___ Surname ___ Date of Birth ___ (dd/mm/yy) Marital Status 0 Single 0 Married Email ____ Daytime Contact Number ___ Home Contact Number ___ Occupation ___ Employment Type ___ Monthly Income (after tax) £ ____ Bank or Building Society ___ House Number/Name ___ Road __ Town/City __ County __ Postcode __ Time at current address __ years __ months Type of residence 0 Council Tenant 0 Private Tenant 0 Homeowner SUBMIT __ = Text Box 0 = Radio Box ## 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 PHP / MYSQL