Windows Desktop Application

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

Project Description:
i need a desktop software application that can be deployed that allows the user to input the information below into the attached pdf form. The users will install the application on their Windows XP, Vista, 7,8 desktop computers.

Label 1: User selects date from calendar
Label 2: User enters in patient's name in caps
Label 3: User selects date from calendar
Label 4: User selects date from calendar
Label 5: User selects date from calendar (page 6)
Label 6: User selects state from dropdown list

I would like a small user interface with my company logo at the top of the application

I would like the following menu options:

->New Report
->Print Report
-> Clear Report

About Us
(I will provide you with company information to create a small splash page)

Also, I would like a small splash screen with my company logo and message that shows when the user opens the application. I will provide you with my company logo and message for the splash page once I have awarded the project to you.

Also, please include all source code and a packager that can be used to package the software in the future if I make changes to the code or splash screen.

Skills required:
Windows Desktop
Additional Files: fillable pdf form.pdf
About the employer:
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