Design a simple application

I need a simple application develope please. It's just basically two checklist for a repair, one before and one after the repair and then turn it into a pdf to be able to email it. I use Mac so it needs to be Mac friendly.

I don't need an app for Apple etc.... I'd like to use it on my iPhone so if it's a web based app even better.

I think it's very easy and straight forward if you know what you are doing.



Thanks