Build a simple PHP form

We want someone to create a PHP form with the following questions. Questions: 1. Startup/Product name* 2. Startup/Product URL 3. Founder email* 4. Founder's name* 5. One sentence pitch* 6. Brief Description* (textbox) 7. Problem it solves* (textbox) 8. Target audience* 9. Startup Categories* (E.g. Mobile app, Web app, Saas, Service, etc) 10. Technology used* 11. About founders* (textbox) 12. Twitter Handle* 13. Startup address with contact no* 14. Logo* (ability to upload & store logo) 15. Screentshots* (ability to upload & store 3 screenshots) 16. Facebook 17. Linkedin URL 18. Startup Video 19. Angel list URL 20. Crunchbase URL After Filling up: He needs to be redirected to a html page to acknowledge that the form has been submitted successfully. Requirements: 1. Make it look good 2. The answers & images need to be stored in a database. 3. Also we need all the answer to be emailed along with image links 4. Basic validation is required