Custom Dynamic PHP Page, With MySQL & Form

Seeking custom PHP/SQL work on a single, dynamic page and MYSQL database table. We would like to build a page that contains a set of empty variables for several links, an image, and some text. Depending on the code entered in the url ([login to view URL]), the code would match those empty variables to fields in a database, using that code as the key (12345, FirstName, LastName, PersonalWebsite, ImageName). The template php page would then contain the placeholders for this information, for instance: <img><a href="[login to view URL]> <span>Hi my name is, FirstName</span> Be sure To check out my website, <a href="[login to view URL]">click here</a> We also need to create a simple form page to add this information to the database. The visual elements will be created in house, so this just needs to be clean, functional page with our required variables.