Customized Prestshop Registration Form

Looking to have a customized registration form for a Prestashop website currently in development. Working with the matrice theme, the form will need to be embedded on a custom CMS page with fields to include: Title (drop down) First Name (text field) Last Name (text field) Company Name (text field) Address fields including postcode, town and country (address look up button would be nice) Telephone fields (2) email field (2 including a confirmation) website address field (text field) 2 drop down fields (winning bidder to be informed) 2 or 3 tick boxes (t's & c's etc....) Submit button File upload button and field are essential for image media files (jpg, png, pdf.......) with a size limit. Captcha would be great but not entirely necessary