Build an HTML form using template

Hi I am looking for somebody to build me a form, as per the details of the attached word document, the black bullet points are the required fields, the red writing is information for the person who is completing the form and needs to be displayed and the green writing are development notes. The form will need to be over multiple pages, with new pages using jquery slide effects to minimise space). Most importantly the form needs to be responsive. I have purchased this template, which i will provide to the successful bidder, for the general style and elements of the form, including the right hand column which must feature in the design, the information here will be edited later. [login to view URL] I am a developer so now hard/easy this is to the person with the correct skill sets, i just require some assistance so i can concentrate on the programming aspect, sensible bids only please.