Simple kiosk style app for android

Hello . I need a kiosk style app for android. App should have two functions accesible via two buttons on main screen: 1) Fill a form with only Name and phone number (Contacts details can be sent by mail to my account, stored in a spreadsheet, etc) 2) Leave a comment or suggestion. Form with name, number and text box for comment. (Comment and details can be sent to my e-mail, stored in a spreadsheet, etc) The app should function in kiosk mode (fullscreen, without letting the users exit the app. After completing the form or after some minutes inactive, the app should return to main screen. The app must work in older android versions (4.0, 4.1)