Create a Web from (UI) and provide source code

We need web developer to create a web form (UI) for inputting multiple-choice question data, option and attributes. The fields and structure will be provided in an excel file. The form has to be mobile optimized, involving html5, CSS3 and Javacript. It will include a lot of drop downs, for which values will be provided. New fields will have to be added directly from the form... The form is to be used for a code maintenance back-end, from where fields will be added, codes created .....and also attribute values selected from drop down list, from input boxes, radio buttons, etc. This form is to be integrated into an existing web application, developed in javascript. A totally Javascript based solution is also welcome. The field values will be dependend on other field values based on some hierarchical structure.