Magento Custom Extension Needed

We either want a new custom extension created or want an existing extension modified and installed in our site (if one exists to do what we want). This is for a Magento v1.6 CE website. This is how it will function.
- We want to create a page that will have many wedding rings on the page (approximately 200 ring images but we don't want a limitation).
- We want check boxes next to each ring. People will be asked to place a check next to the rings that they like, answer a few questions, and then, when they complete the survey/poll, the data is saved to a downloadable file (for us to review).
- On the "Thank You" screen, we want to give the person a discount coupon that they can use towards a purchase in our site.
- We would need to be able to have multiple polls/surveys where we could update the images and questions.

When replying to this project, please specify:
- Will you create the extension or will you use an existing extension?
- How long will this work take to complete?
- When can you start?