Android App - Code user input form

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Bids
32
Avg Bid (USD)
$547
Project Budget (USD)
$250 - $750

Project Description:
I have a Ap that i started building. Im at the point where i need some help.

I need a input form that accepts Email, name, age, county, city, state, sex, bio, and allows them to upload a photo to my server. The ap form also needs to submit that data to my database.

I will provide the started app code. The server side programming will need to be done in c#. I can provide my visual studio SLN if needed so you understand the table names in the DB.

The form I need replicated can be found on the site here. http://bangmeornot.com/addmember.aspx

Skills required:
Android, C# Programming, Mobile Phone
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