Visual Design/layout of 9 form fields (not technical)

We have certain form fields we'd like to request on the front page, we're interested in a layout of the fields that appears visually acceptible. An example exists of a limited number of fields at [login to view URL] Fields to be asked from users: Title (small pulldown) where Mr and Ms are the 2 options First name/Last name Address Postal Code/Place/Country (pulldown) Date of birth (pulldowns)/E-mail Submit button should say "Yes" followed by a sentence like "I agree to the terms and conditions" Fields do not have to be in the exact order/lines as described above. Would be interesting to make it as compact as possible so as it does not take too much space or appear like a lot of work to fill out, but should not be made so small that visible impaired have major problems and should be ok for users of 1024x screen resolution. The fields are to be in German, this may impact some title sizes of the fields. If any invalid values are entered, a new page will show with the invalid fields. Thus you do not have to consider space for error messages. German words Title=Anrede Mr/Ms = Herr/Frau Address=Adresse Postal Code = PLZ Place=Ort Country=Wohnsitz Birth = Geburtsdatum Yes=Ja Please display your ideas in a URL, the most appealing design is the bid that is selected. It has to be a design that you can deliver in HTML, not an image that might prove impossible to make into HTML. Bid is accepted based on your design, and payment is made based on the HTML working OK. A little problem: When pressing TAB on the last field our current form does not jump to the submit button, if you can fix this - it's of interest (not a requirement for this project). ## 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 Linux PHP