534452 HTML5 Mobile Form Required

I want to make a HTML5/CSS3 mobile friendly version of [login to view URL] which will work with iphones, ipads, android and blackberry. The existing form is by no means perfect, but I would like the mobile form to be as robust as possible This is quite complicated. The form is written in classic ASP and has quite a lot of javascript in it. There is also quite a lot of SalesForce CRM codes in there too. The output is written to a MS Access database too - we cannot alter the structure of the database as it wil be used by other existing forms when live. I'm not sure what capabilities HTML5 has, but it would be nice if we could keep some of the javascript features it has: I have explained these features in a video here, please watch it before bidding for the job: [login to view URL] But essentially these are: 1) there is a datepicker where dates in the past are disabled and it is only possible to select either the current year or next year. The default date is Today, so if nothing is entered, today's date is chosen. 2) if the check box is selected for weekend hire, the drop down menus for weeks and days are disabled and the weeks is set to 0 and the days is set to 4. 3) I'd like it to be impossible for people to enter a birth date that means they are under 21 or over 75 4) I have used a prepopulation script from here: [login to view URL] which I would like to still be able to be used. I use this to send emails from my list which will go to (for example) [login to view URL]@msn.com&firstname=bill&lastname=gates This form is on my testing server, when finished it will be copied on to a production server, so you can work on it live if you wish. I have set the budget reasonably high for this job, because I need someone who has experience of making mobile HTML5 forms, not just somebody with a copy of Dremweaver CS5.5 Before you reply, please watch the video I mentioned above and make sure you have understood what was required. If the winning programmer does this well, I will have more work like this later on.