Mortgage Calculator Widget

We need a mortgage calculator creating that can be installed as a widget on our existing wordpress website. The calculator should allow the user to enter specific details about a mortgage and return specific calculations. Upon returning the calculation the user should be presented with 2 options: 1. Apply for this mortgage - upon clicking this option it prepopulates an application form on another page that you will create 2. Subscribe for information - upon clicking this, the user can enter their email address which should go into our autoresponder lists (aweber)