image / form maker

I need to have an online image / form maker where a browser can create their own form image and "send" the final to our email address

[url removed, login to view] (kind of similar to this although simplified)

see attached files for a better idea

(just need to be able to modify the text and add a picture that stays with in the an area on the background image. -- then there will be a regular form below they fill out and click send) -- "we" receive the image /form that the browser updated.

If you have any questions please ask.

Skills: HTML5, Javascript, MySQL, PHP

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About the Employer:
( 177 reviews ) Toronto, Canada

Project ID: #4140041