If the output of the form is to be emailed to you, I can make you a script to recreate the form on your site. You won't need to do anything other than making the form on jotforms and then entering the address into a textbox that the script will show. The rest will happen automatically: it captures the html, makes adjustments, and add php code to handle email sending part. Of course you also need to tell under what name you want it to be saved.