350762 Quote form

I need a QUOTE FORM only for our website the same as the one on [login to view URL] It needs to function pretty much the same especially how the information changes with product selection ... etc When the information is submitted, the following page is displayed with the customer name as it functions on that site. The information should be stored in database and accessible so we can access this information at a later date. Yes, will need somewhere that can list previous quotes (name, date, time, etc).... but not password protected. We do not want the entire site re-created, just the quote form.