Debt Form Already Created - Need Back End Done In Php and posting to my CRM

I have the graphics for my debt form already created. I just need the php file modified so when the client hits submit it goes directly to my CRM. I have the posting instructions for my crm and would be providing everything. I also need the fields in the .php file changed to match my crm. It is a simple task for a php guy but I don't have time to learn it at the moment. I need it done asap. I will provide http posting instructions as well as the fields to match my crm. Please get back to me asap if you are interested. thanks ## 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 linux server.... php