Hotel widget needed for a WYSIWYG (Wix) website

PLEASE READ BEFORE RESPONDING: I have posted this once already, but due to an overwhelming amount of generic responses from freelancers that claim to "understand my project requirements", I have decided to add a new qualifier. In order to be considered for this job, you will need to start your bid message with 1). the word "Penelope." followed by 2). a sentence or two paraphrasing the job as you understand as well as 3). how you would accomplish my particular project (strict HTML, PHP, etc.). I need someone who clearly understands ALL of the job requirements and isn't just serial-applying to jobs. I WILL NOT READ YOUR SUBMISSION UNLESS THE ABOVE 3 REQUIREMENTS ARE MET. My company has built a hotel website through WYSIWYG website builder, Wix. Unfortunately, Wix does not offer the ability to create a hotel reservation check in form as we need it. We need a registration form nearly identical to the one shown on [login to view URL] (see attached image as well). There are two catches: 1). The coding must be done entirely in HTML. While Wix does technically allow Javascript and other script languages, I am unable to attach additional pages/extensions. Wix only offers an HTML widget. 2). The information entered on this widget needs to mirror company's existing form through third party (viewable at [login to view URL]). That means that when users fill out the information on OUR page and hit submit, the widget needs to mirror the exact same information to not have to re-enter the information the second time. It would be ideal if we could completely bypass this landing page altogether if possible so that the form auto-fills and submits landing users on the destination page. This is a one-time project and we are more than happy of a very small scale, so our budget is not huge. Before applying, please be sure you are confident you can meet both requirements listed above as the failure of the selected freelancer to do either will result in forfeiture of payment.