Convert PDF Application Form into XHTML Form

We have an 8-page PDF application form we need converted into XHTML ready for us to implement as an online application form. IMPORTANT REQUIREMENTS - PLEASE READ 1. The converted XHTML form must validate to XHTML 1.0 Transitional. 2. The layout of the converted XHTML must mirror (or be very similar) too the layout of the PDF and not exceed 750 pixels in width. Although there is no restriction on the height of the form we don't want large spaces between form fields and elements. 3. The value of each field MUST be entered AND mirror the PDF fields so that when received via email, fields are clearly defined. 4. Table or CSS layout is fine as long as the code validates too the above. 5. Full payment will be made once the XHTML has been received and checked against the above. 6. We don't require any form validation ONLY the XHTML. Finally 'onFocus' we would like the form fields to clear so their empty and ready for the user to enter data, any further questions please ask, thanks.