Form for a member section - E-mail + MySQL

I currently have a Website with a private section for member. This is a corpo. website in French, but I will provide you all translation needed. I need a new form than user can fill. The information is sent by e-mail to ADMIN, to user ( confirmation) and in the MySQL Db. REALLY IMPORTANT, the form have to remember the last choices of the user. So when he want to fill it again, he see the last information he entered. This form is going to be really similar to a form I currently have, so I guest you will be able to take some code from this. Have a look to the muckup in attach piece. There is a repeating box, mandatory fields, fields than cannot be choosed both ( Ex. yes OR no) . etc... The muckup is in table, but you have to do it in CSS . No table. See attached piece Must be 100% W3C and you have to do a REAL and HUGE quality testing. I do not want to have to check after you again and again. We will work on test server and transfer the final form on real server once done. Project is a little bit urgent, please, indicate me when you are ready to start and your REAL time estimation. Do not bid 1 days if you are planning to take the next 3 days off ! ;) Good luck !