419877 PHP Feedback Form Application

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Project Description:
I need an application similar to: http://bit.ly/7P5zf

It should have the following features:
-Templated feedback comment card design that users can just add their logo to.
-Should capture the page URL where the feedback was submitted.
-Should have a mailing list feature that emails, on a daily basis, the page rating, URL and comment in an attractive and organized email.
-Back-end should allow for Excel or CSV export of the comments, should allow ranking based on rating for pages. Should display geo-location of users that submit feedback. Should make use of open-source flash charting tools like: http://www.fusioncharts.com/free/gallery/ or http://teethgrinder.co.uk/open-flash-chart/

Must be designed using Web 2.0 or 3.0 technologies to be clean, easy to use and beautiful design. Should be built using either PHP or Java with a MySQL database.

Skills required:
Adobe Flash, Anything Goes, Graphic Design, Java, Logo Design, MySQL, PHP
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