Add login functionality and form to email

Hi i have existing wordpress site [login to view URL] I have made some design changes and want to upload them . I have a [login to view URL] hosting accout . Apart from uploading the changes..i want the form on the left to be emailed to me whenever a user fills it. To avoid the same user entering his details again and again, i will like to save his details , so that next time he comes he dont have to enter his details again ## Deliverables 1) Complete and fully-functional working program(s) in executable form as well as complete source code of all work done. 2) Deliverables must be in ready-to-run condition, as follows? (depending on the nature? of the deliverables): a)? For web sites or? other server-side deliverables intended to only ever exist in one place in the Buyer's environment--Deliverables must be installed by the Seller in ready-to-run condition in the Buyer's environment. b) For all others including desktop software or software the buyer intends to distribute: A software? installation package that will install the software in ready-to-run condition on the platform(s) specified in this bid request. 3) All deliverables will be considered "work made for hire" under U.S. Copyright law. Buyer will receive exclusive and complete copyrights to all work purchased. (No GPL, GNU, 3rd party components, etc. unless all copyright ramifications are explained AND AGREED TO by the buyer on the site per the coder's Seller Legal Agreement). * * *This broadcast message was sent to all bidders on Monday Apr 20, 2009 3:31:23 AM: i have added the files to be uploaded in the bid request ## Platform wordpress