Build me an order page for my website - please read full description and look at attached files and weblinks

Add a form to this website: [login to view URL] Similar to contact form: [login to view URL] Must look good Must include data in attached with boxes to complete for all forms all fields must have names so can be emailed via php must be a https file Will not share FTP but will share any files needed Would like attached logo to be included Graphic presentation is key, if this looks good will have more pages (without the form element for you to add)