Basic HTML (word form to HTML form)

I need this word file converted to nicely structured HTML. The RED text in the word file is ment as guidance for the person who converts the document, and should not be included in the final version. A .php page must be made to collect the results from the form and send to a specified mail address. ## Deliverables 1) Same layout 2) Clean code 3) Exclusive and complete copyrights to all work purchased. ## Platform HTML, php