Wordpress Referral Page Development

I have a website built in wordpress. The website needs a new page that will be a "referrals" page. On the page, there will be some text that I'll write, and then there will be a login w/ a user (email) and password. That will take the user to a screen will they will be able to (1) enter a new referral and (2) view all the referrals associated with that user.

The screen that will allow them to enter the referral will have
1. Referring company (prefilled based on user) + date (prefilled) + referral percent (prefilled - unique to user account)
2. Name of referral (i.e. the customer that they will send to me)
3. Phone/ Address of the Referral
4. Description of the project + an area for additional notes
5. Enter button to commit
6. At commit, I will be sent an email

Also they will view all records associated with the user that are open or closed ( but only the records for that user - not other users). They will NOT be able to modify commited records.

Admin screen will be exclusively for me accessed by my admin user / passwd

I wil be able to
1. View all records (open and closed) for all users
2. Update records to include
a. job accepted / awarded (check box) + area for notes
b. amout for the job / date the job is completed.
c . established referral percent (static value like 15%)
d. amount paid to referring company (amout * referral)
e. amount paid out / date / check number.
f. button to close out the record.

* At any time a commit is made to a record., the customer will receive an email with the details of the job record.

I will set up the initial user account which will include user/pass and agreed percent for each referral. User should also have a means to change their password.

Please let me know time lines and cost for completion.