Create a Mobile Website -- 2

I need the following mobile website creating for internal use simple 6 digit code to unlock page and move to input screen (6 digit code pre fills relevant boxes with engineer name - i.e. code 123456 fills in Joe Bloggs in Engineer name) Input screen as follows Box 1 - Input Job Number Box 2 - Location (text box) Box 3 - Pop account - (Drop down menu) Box 4 - Job Name Box 5 - Comments Box 6 - KMT Comments Box 7 - Engineer Name (Pre-fil on Code input) Additional Fitter Then 8 optional "click to add photo" then opens camera or select from mobile device images Send Once they hit sent to needs to send 2 emails Subject - KMT Field Report Body - See below Attachments - All photos 1 - Email KMT with all information and all boxes plus all photos sent as attachments. 2 - Depending on Box 3 - there will be a distribution list of up to 10 people per "pop account" so if POP account A is selected it send the 2nd email to Pop A distribution list. This email will be as above EXCEPT KMT Comments, Engineer Name and Additional Engineer field It will also need to confirm to the engineer that it has sent the emails then click return to home. I will need to be able to edit the following items Engineer codes for access + Add and Remove Field names Drop Down Menu Content POP Account names + Add and remove POP account distribution list + Add and remove Devices will be Android and Iphone Logo Attached - Program to be called - Field Report