Form / page / plugin in WordPress

The job is to develop a form that has to be run in wordPress from a menu-item. The form and the functionality is described in details in the attached document. The milestone payments are: 50% when the form work perfect on your environment 25% when you send the deliverance to me 25% When it works om my environment The milestone payments are released when the milestone is reached and tax-invoice is received. If your company is a EU-company, the bid and invoice should include your tax-number,