I need a quick Petition Style Website made. Most probably 2 pages. Simple page will require a Title Header and Body Paragraph section with a "Petition Signed" counter at the bottom. Underneath the counter will be the small form-to-be-filled to sign the petition, which once submitted, will display a thank you message and have the user redirect to the second page where all the signers signatures and graph of fields 3 and 4 (graph explained below) are posted for public viewing. Also on the first page, under the fillable form, there will be a link to go direct to the signer's page where people can view the current list before signing themselves.
For the fillable form (basic design):
1. Radio Button: "Anonymous Signer:" (by default, this option is off and the "Name" field is Required, but if selected, the "Name" filed is grayed out, user being unable to enter anything, but is automatically filled with "Anonymous User 1" and counts for each one on wards.
2. Text Box: "Name:"
3. Text box: "How many cars are parked at this house daily?"
4. Text box: "How many members in this house depend on this road to be developed for easier and quick access?"
Captcha (simple) to ensure human verification.
Submit (button) View Signatures (button)
At the back-end, I need an option to print (not for public printing) the list with numbers beside the signatures, allowing for easy counting and verification of the number of signatures. Also need a bar graph with one row (horizontal line) depicting the total Field 3 and a second row depicting total for Field 4.
Any other suggestions are welcomed to make this petition more attractive and functional. Although very simple, i would like it to be as clean as possible and not at all messy. For the 2nd page with all the signatures and graph to be viewed publically, it should be in a nice chart with the following columns: Numbers, Names, Cars Parked, Family Members.