html / php survey that shows individual results to user

Your task is to make a survey based on an html form field. key info - max width is 480px. - The survey will have 6 questions - 1 question per page - user will answer questions in (and only in) a textarea - when the survey is complete, it will take them to a page that will show all 6 questions along with the users answers. - on the results page, they have an option to email the results (which will include the questions and answers). Would be ideal if this was sent in an editable html template. - I (as admin) do not need to see results, so no need for storing for me to see. You have a blank canvas with this, It does not need to be styled, just the basics. Feel free to add any extra things to this in the bid proposal (such as survey progress bar, save button, view past results). Ideally, i would want this to be offline (so maybe just html) If anyone can implement this so you only need to be online to send the email of results, this would place the bid proposal higher than others. This will also be used by mobile users so writing to a txt file or creating a html page locally is not an option if you try to implement this offline. thanks for you time, please send me your best offers and additions.