Online form - repost

Avg Bid (USD)
Project Budget (USD)
$30 - $250

Project Description:
I have a joomla 3.0 website. I need a custom form created that collects some basic information. I would like a few of the fields to be conditional based on previous selections as well as some form validation.

The trick is that I need this form to submit to an email address but I need it to submit as the person filling out the form, not the generic web server address.

There may also be a small ldap part to there where the email address is validated but that is still open. I may just have the form query the user table for the website.

Additional Project Description:
10/12/2013 at 9:16 EDT
Additional information required. Mostly Drop down box information. RSFormPro is loaded on the site as well if needed.
Here are the form requirements. Start with this.

Fields for the form:
Requestor Firstname and Last Name
Phone Number in xxx-xxx-xxxx format
Email address

Then a question. "Is this a request for security design or a new project?" Yes or No. If YES show the account Number information

If no, show the drop down

Service Request Type: Programming, Service Request (if they pick Service Request) then show below. if they pick Programming, scroll down to the Programming section...

Servie Request SubType: Bollards, Elevator, Intercom, IP Lockset, Lock Issues, MRDT/Keypad, Prox -Card Reader, Release Buttons

Service Request Category: Bollards (got hit by vehicle) (Stuck in Down Position) (stuck in Up Position)
Elevator (Not following schedule) (Won't move on card swipe)
Intercom (No Picture on Screen) (Won't release Door)
IP Lockset (Cannot Swipe Card) (Keypad not working) (Lights Flashing on Front)
Lock Issue (Lock won't release), (Loose), (Will Not Lock), (Won't Stay Unlocked)
MRDT/KEYPAD (Change Functionality) Needs PIN Changed, Won't stop beeping)
Prox - Card Reader (Swipe - No Read), Swipe - (Read/no tone)
Release Buttons ( Can't use), Won't release door

Programming SubType: Card/Prox Time Zone

Programming SubType Card/Prox (Add, Edit, Remove)
Programming Subtype TimeZone (Add, Edit Remove)

Each drop down should have an "Other" which just takes them to the "description box"

everything in the Type, Subtype and Category should appear in the subject line of the email that is sent

The description should appear in the body of the email

The form should be mobile friendly.

Before they can see the form they need to login to the website. the login might be controlled by LDAP, but not sure at this point, we can worry about it later.

Please install CAPTCHA

Please make a way that items can be edited if needed.

when the email is sent, it needs to be sent as the user that filled out the form.

Skills required:
Joomla, MySQL, PHP
About the employer:
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