Developing Web Registration Form

I need to create an Web Registration form for my website. Prototype is provided. you will have to make ONLY the registration screen using html and css that should post to a back end using form post. The design should be inside <div> and use inline styles. Requirements ------------------ Expert in Html, Css, js, Designing web sites etc. Deliverable within expected time from the date of given work. See the attached images, you will just need to do the registration screen on the space provided. *** Note: This project is only for creating the registration form in HTML and Css (maybe Js too). It should have a form to post the values to any backend server *** ## Deliverables Follow the format in the below picture and the registration form should be placed in that particular area looking at the size of that area. Give a margin of at least 5px on all sides at the registration screen. Your free to make necessary adjustments to my design. A small help icon needs to be placed next to some of the field labels. A tiny terms of use link should be there at the bottom. Send a image prototype with your bid.