Create a professional form in Microsoft Word

Seeking expert to create a professional form in MS Word. Its only one page. Image file will be provided. Need a duplicate of the image file provided. The right candidate must: have experience in creating business forms prompt in responding to emails/chat Must be able to use collaboration app MEET DEADLINES Able to use the file sharing program Dropbox Adhere to confidentiality. Will ACCEPT ALL BID OVER RANGE.

Deliverable must be 6 am EST, Wednesday Dec 1