Birthday Collection App - MS Access/c/c++/vb/.NET

In need of a basic application which will run on a laptop in a resturant. I have 12 access db files containing birthday information, name, address, phone, etc. The application will have a image for the background which i will supply, and then a simple form for the customer to input their birthday info. The application should write to the appropriate db file based on the month of their birth. All files are currently on the laptop nad will stay that way. It would be nice if the background image could be changable, and also if the application had no visiable menus. I also require the source files along with the compiled version. This is a simple project for someone with the right skill set. Thank you in advance. Please only apply if you can do the work. Also all canned messages will be ignored.