Build me a responsive web form.

I need a single page website with a form similar to this one [login to view URL] but with a cleaner and minimalistic design, somewhat like this defunct one [login to view URL]://[login to view URL] The backend application is about 90% done and will be responding to UI events on the form, e.g. when the user selects a car make (a list of which will be obtained by making a JS fetch or XMLHTTPRequest to an endpoint) from the make drop down, a list of models belonging to the selected make is obtained from an HTTP request in JSON format. So if the user select Audi, a call is made to https://endpoint/models?make=Audi and a JSON object containing values such as A4, A6, Q7 and their respective engine capacities, etc is returned. The Year drop down has values which range from (current year-7) up till current year Required input fields are: - Year and Month of manufacture (separate drop downs for year and month) - Vehicle Make - Vehicle Model - Engine capacity (read only text box. Value to be obtained from endpoint upon model selection) - Calculate (with captcha) ( and reset buttons - the calculate button dynamically creates a table in a new div section with key value pairs obtained from an endpoint - of course without reloading the page. Reset button removes the table and clears the fields/selections Ignore all other fields in the example forms shared above Other desired features: - an ad banner for hosting image ads - ad blocker detection and overlay message preventing usage of the form if an ad blocker is detected - a disqus (or similar) widget for conversation at the bottom of the page - a social media button linking to the website's twitter account: @ushurucalc (so no need for contact us or feedback links) All endpoints for HTTP requests will be provided on project initialization I am happy to take questions on anything that is unclear.