Data Input software program with output in a document form

Avg Bid (USD)
Project Budget (USD)
$250 - $750

Project Description:
I would like software developed to capture information discussed in an interview. It will have five pages with information in drop down or selected buttons. The information will be processed and have ending format of a word document.

A data source will have various option of possible answer and a box to put addition needed data.

When specific data buttons are selected it will also provide additional screens specific to the selected item.

Skills required:
PHP, Software Architecture
About the employer:
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