A poll form to recollect market data.

This project received 11 bids from talented freelancers with an average bid price of $179 USD.

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I need to create an image that fits the current design, on the main index page. This image will link to a new page (also maintaining the format) that will display a form with 7 questions, that will be answered through check boxes (it will be a poll), at the end of the poll and in the same page, it will have text boxes to enter personal data from the person filling up the poll [name, address, city, phone (work or home), cellphone (all these will be required fields) and comments].

This data should be saved on a .cvs file (duly tabbed) or sent as text via email (also properly tabbed), whichever is easier&faster.

I'll provide the index page as a template for the poll page and in order for you to enter the image that will lead to it.

This job needs to be finished today.

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