PDF Online/Offline Form to Access Database

I need a PDF web-based form that can be filled out online or saved offline and then emailed from the form to the form manager. The form manager then can review the form and then published to an access database from the form. There needs to be validation within the form or database to keep the data accurate and from being duplicated. An auto number stamp with data and time on the form will work. Once the form has been uploaded and entered into the database the user needs to receive an email confirmation stating the form has been sent. Also when the form manager publishes the report to the access database, they will need a confirmation email or pop-up stating the form has been uploaded into the database. The current paper form is one page with 5 sections, each section having 2 ??" 3 subsections. The fields will need to be drop down menus and text fields, with validation on various fields. The time frame on this project is relatively short. The form and database will need to be delivered in 2 weeks. The winning bidder will also receive the current form. ## 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 Adobe Acrobat 5.0 Internet Explorer 5.0 Access 2000 or greater