Creating a PHP form (template given) - repost

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I need this [url removed, login to view] file to be converted into a PHP form, you can see I have already made the entire webpage and also the form, all of the editable fields need to be converted into a PHP form so that when the form is submitted it sends all of the information to an e-mail:

All of the forms and designs need to stay the same, but wherever I can write something it should be a php based form.

Could someone help create this form into PHP, I already have a website server ready for this for testing purposes, payment will be made once the form is in working order. Thank you.

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