284440 Generate Embed Object code

I need a very simple web form-based app that allows a user to paste in a URL text string and then make several feature selections on a web form. On Submit, the app should then take the user input variables and create OBJECT embed code of a defined format that incorporates the user selections and provides the resulting code for the user to Copy to their clipboard. A Color Picker is required for two of these variables. A Preview of the Object code (based on current selections before Submit) is also required. I'd like input as to what platform & development tools would be best to create the app for maximum ease of use and cross browser compatibility. The cooler it looks...the better! ;-) I'm looking for a developer that I can build a long term relationship with to modify this app in the near future and also to engage in additional projects as they come up. I am looking for a very fast turnaround on the project of a few days max. if possible.