Create Form to Specifications

I want you to create a form for me that has the following fields: First Name(textfield), Last Name(textfield), Email(email field), Upload Your Image(Image Must be in .JPG Format)(file upload field), and a comments area. The file upload field must allow file uploads of .jpg files only. The form must send all data to an email address. The form must send the picture uploaded with the file upload field as an email attachment. All fields should be required but comments. You will work on this using your own environment. I will send you the sites files in a zip to your email when you accept the project. I will also send you a PNG of what the form should look like. I will send you information on which email the form information should be sent to. If you would like a png of the desired form before bidding, please let me know. Thanks, -Sarah