Application form Fix and alter

My small financial services website has a .php Loan application form that isn't working correctly and also needs some small adjustments. I need the application fixed so that when completed it sends an email of the completed application to 5 different email addresses, it is'nt doing this at present for some reason. I also need a couple of other adjustments, such as when the application is filled in with 2 names, the second one shows in the email from as, i require that the first applicants name always shows in the email subject line. This is a small job so please no crazy, stupid prices, I DONT PAY UPFRONT ! If awarded the project i will put money in Escrow and release once i have received the files and tested them on my server, Please check my site and let me know if you can carry out the job, dont just send me a pre-worded message, etc. if you do this i'll just delete your bid. Please send me a message regarding this project. Regards Lee The site is www.best-secured-loansDOTcom