Mobile App Developer

I need a mobile developed (android/iphone) which submits data to this form (http://www.abqthemag.com/bestofsurvey2013a.php) and submits the form.

If this is something that you are able to and quickly, please let me know. You must have current skills.

Thanks,

Stan

P.S. If this works out well, there could be other jobs to follow.