simple php form and one page template design

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

Project Description:
i need one php form as : i will give you more details, in PMB,

Second thing i need one page template design in photoshop and converted to html/css.

i will send you a link for this too in PM.

Thank You

Very Very Very URGENT, if you cannot do the for today in an hour please dont bid.( i dont want to cancel my projects again and again).

Thanks again.

Additional Project Description:
10/03/2008 at 5:37 NZDT
I need only form done in an hour , not everything.

Skills required:
Photoshop, PHP, Website Design
About the employer:
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