PDF form - encrypt and email

Avg Bid (USD)
Project Budget (USD)
$10 - $30

Project Description:
I would like a blank form to be created for me that does the following:
Has a signature box for an electronic signature
Will work on an iPad/Android Tablet
Send a copy of the form filled in, to a specific email address
Encrypt his form prior to sending

As an example, if someone wants to decline getting a flu shot, I will put the middle wording in place, key in a couple of hidden fields with data regarding the type of form it is ie Flu Declination, Fit Testing etc..

The person could take a tablet, put in their name, employee number and then sign it, click submit and have a cop of the PDF form complete sent via encrypted email to a specific email address, which should be coded into the form.

Skills required:
Adobe LiveCycle Designer, PDF
Qualifications required:
us_eng_1 US English - Level 1
About the employer:
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$ 35
in 2 days
$ 30
in 3 days