Ajax Form Using Multiplication

I need someone to create a form that can do calculations (multiplication, subtraction, and division). I have attached a prototype of the form. DO NOT BID UNTIL YOU LOOK AT THE FORM. The form involves two (2) fill-in entries that would already be populated with a number when the page first loads but are changeable by the viewer, a calculate button, and two (2) results display field that changes based on the two values above. The formulas involve multiplication, subtraction, and division. The results would have to be displayed in a specified font and size (Arial Bold, 18 pt.). Two email data fields would also need to be coded in. Job would need to be completed by Friday, July 11, 5 PM CST, approximately 48 hours after the job is awarded.