A Simle PHP Form

i need a Form like following Link ASAP [login to view URL] and i need this abilities: 1. simple to use (a simple form) 2. Database must be in SQL. 3. create a simple view for DataBase(it is better to be Password protected)(for viewing information of DB) i am a web developer, i know it is a simple and easy work about 1~2H for a pro-person. max bid: 50$ Thanks. Akbar Goldust.