Need a Custom drupal form

Closed - This job posting has been filled and work has been completed.

Job Description

I need to have a custom form created in drupal as module. The work must be done AS SOON AS POSSIBLE in the next hour or 2.

the form will have 15 inputs:
-5 text fields
-6 dropdowns
-2 check boxes
-2 file uploads

The form will have to have a validator to make sure inputs were entered correctly.

Form will have to upload 2 images to site, and send an email with all info entered and links to the images.

Willing to spend $15 only please dont bid if you dont comply.