Need A Form Created

I\'m looking to have this same form created for me site so I dont have to use wufoo, I would like to add an upload file option to it.

So if this is something you can do please email me your price also if you have Skype or Phone Number

This is the link to the form
http://digitaldigg.wufoo.com/forms/printing/

also wanted to add two upload spots to it under (Quantity) something like

Front Image: --------------- browse
Back Image: --------------- browse

If you have time please get back to me on this.