Develop a Image upload form

I want to develop a simple form which allow to upload jpeg/jpg/rar/zip/gif files with progressive uploader and with some text fields like name, country, software used, description, image title etc.... And all this information mailed to my gmail account. I need little customization or control over adding/removing the fields easily If form is done in ajax, mysql 5.5+ compatible, php5.4+ compatible then that will be fine. Everything must be professional, properly written code, secure code from mysql, with security from spammers so they dont exploit the form. I am not looking for recaptcha to add in the form, but still ways to save from spammers. I like to add this form in already designed php page, so you need to adjust the things little accordingly. if need more info then let me know. Good price bidder get many more big projects from us, this is just a start to find the correct coder.