Our clients currently fill out a word doc to register interest in our services and either email or fax this to us. We would like to convert this word document to an online form. Roughly 20 required fields to be filled in and an email with the information sent once complete. Our company services clients in 2 regions and would also like the email to redirect to the appropriate email based on the region selected. An email should also be sent to the submitter to confirm that it has been successfully submitted. Our current site is developed in ASP which is ok, but I would prefer PHP so I have the ability to maintain it due to a little PHP knowledge.