PHP with simple mySQL entry form

Very small and simple job. Must be completed in 24 hours.

3 PHP pages:
-1 x web browser (must have auto-recognition if using mobile phone and forward to mobile site)
-1 x mobile browser (must be compatible with iPhone/Andriod/Blackberry)
- 1 x admin login to show saved data from table Member_Location. Info to be grouped by "Suburb".

The lorem ipsum text on the web browser PHP must be easily editable.

Form on each which enters the following information into the table Member_Location:
- Date of entry (Automatic)
- Name (User input)
- Email (User input)
- Suburb (Drop down list from table "Suburb")

"Suburb" table will contain list of suburbs (TBA).

All images used in screenshots will be provided to the winning bidder.