creating an online application form

I need to implement an online application form for users to fill out their contact and property's details in order to get a free home valuation report. The application form is similar to those in the following sites: [login to view URL] [login to view URL] [login to view URL] You may use postcode 2200 to try those sites out and have a better idea on what is involved. the application form should be implemented to my website URL: [login to view URL] The purpose of the application form is to receive and record the user's details and an email is instantly is sent back to the client email address with some relevant information that I will provide. please note that I am only covering about 100 suburbs\postcodes. ## Deliverables any further inquiries or any clarification needed, please do not hesitate to communicate it with me on RAC chat.