PHP Contact MySQL Data Processing

* NOTE * Freelancer Must Show Experience of Coding for Passing Data Value to Script Form Value from Email Autoresponder such as MailChimp, iContact, or other eMail Service Provider Form PDF Outline attached. Yellow boxes only. Links are active. In need of a freelancer team to establish Password Access User Authentication format including - Build simple MySQL Database to Establish Membership format MySQL database 6 to 10 fields including, image url in Member Database. Data will be loaded by the Employer and is not part of this project. - Code for Passing data from Member Database ( 6 fields) to Autoresponder eMail request form. See HTML of form in attached PDF. - User will Access Main Page after entering their User Access Email Address on single pages already in place. - Database for Customers that are entered into Primary Review Request Form which the Autoreponder request form. [login to view URL] (see grayed out fields at link above) Data in grayed out areas are to be passed to the form based on Member Authentication Access (User Email Address). User will complete form above as a member and submit form. Contact data enter must be passed to MySQL Database without interfering with Same Data being Passed to Autoresponder by the code / script contained in the form. Note: There are 2 Forms that require the exact same value data to pass in the same manner. Therefore, the task requires 2 to 3 Databases. Member Database Contact Reviewer - Form 1 Contact Reviewer Text - Form 3