Add functionality to this Form

Hi, thanks for your time. My coder is on vacation and I need to change a few items in an HTML form and get the form to work nicely (we have not added functionality to the form yet). We want the information in the form to get sent to a couple email addresses and we want the information to be in the correct order when sent. Here is the current form <[login to view URL]> Also, attached is a new version of the form (toward the end of the document) and we want our HTML form (or php if you prefer) to match the form in the Word document. The client changed the form and I don't have time to alter it. Deliverables: 1. Change the HTML form to match the form in the document attached. 2. Add functionality to the HTML form(or php) thanks for your time! Mike ## 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 html, php