Convert PDF form to Word

Hi, I'm looking for someone to convert a pdf form that I have into a word form. The pdf form (attached) works well but has two major problems unless you have Adobe Pro: - You can't save the content as you go; and - the email pdf button doesn't work if you software isn't good enough. Therefore I'd like to re-create the same form with the same (or similar) functionality in Word and the same look and feel. You will see from the form that there are various drop down menus and conditional programming in this so in your bid please confirm how you would adapt this to word and if there would need to be any amendments. Note, it is more than one page. Further pages are added when you select your options. Thanks Nick