Create Multi-Part Web Form

I am looking for a coder who can develop a web based version of a form we use in our office. The form will have multiple steps or parts and the data will be put into a simple mysql database of your design. There are about 200 fields that will be split into categories/steps. Over half of these are fields are simple check boxes (with the option to explain details if the check box is active) and the others are mostly text fields. There is very little validation required (just for basic things like address, phone, social security number, etc.) All fields are currently in a paper version of the form in a .doc file. ## Deliverables 1) Complete and fully-functional working program(s) in executable form as well as complete source code of all work done. 2) Deliverables must be in ready-to-run condition, as follows? (depending on the nature? of the deliverables): a)? For web sites or? other server-side deliverables intended to only ever exist in one place in the Buyer's environment--Deliverables must be installed by the Seller in ready-to-run condition in the Buyer's environment. b) For all others including desktop software or software the buyer intends to distribute: A software? installation package that will install the software in ready-to-run condition on the platform(s) specified in this bid request. 3) All deliverables will be considered "work made for hire" under U.S. Copyright law. Buyer will receive exclusive and complete copyrights to all work purchased. (No GPL, GNU, 3rd party components, etc. unless all copyright ramifications are explained AND AGREED TO by the buyer on the site per the coder's Seller Legal Agreement). ## Platform PHP / MySQL