Create a upload page for images and documents using javascript and php

Hi, I need a freelancer to create and design a single page site to add to a sub domain to do the following ( I am aiming for a cost of no more than $400 ). 1. I need an Image upload box, must do multiple uploads, must do drag and drop 2. I need a document upload box, must do multiple file uploads, must do drag and drop 4. must have a single line text box ( must validate to require text, later use for email subject ) 5. must have a multiline text box ( must validate to require text, later use for email body ) 6. must have entry fields for credit card ( card#, expiry, ccv etc ) ( must validate card details ) 7. on submit of form show a pop up model with the below details / program flow 8. must accept client login details (with forgot password option) and fetch client details from our api ( work with no refresh ). If client details do not exist then must show a registration form and register client and submit to api. 9. send email to email address with the notes in the body and download links for the uploaded files. 10. send credit card details to our api to be processed. 11. redirect client to a complete / thank you page Please ask any questions you like before bidding. Chris