Cell phone unlocking API integration page

Hi, I need to integrate an API into a PHP page which I will then host on my own servers. Below is the documentation given by the site for the API. I will also need a database setup. Basically, I want my customers to be able to submit their phone's IMEI number (15 digit serial number), their phone model, provider, email address, and country which will then be transferred to the company's unlocking calculator server. I will give the winner my individual API key, however, the documentation given by the api admin is attached which should be enough for a quote. I use a system called TrialPay as the checkout system in which customers complete an advertising offer in return for their unlock code. Please create a free TrialPay merchant account at [login to view URL] if you win this post so you can see how my end will be integrated... This should not be difficult, only around a $30-$60 job... Again, I only want a basic page with a form, and a confirmation page as well as confirmation emails sent to both me and the customer. I will provide you the email templates. I would appreciate it if you could possibly have some sort of simple admin control panel so I can change these messages and settings at any time. URLs should be one use only and customers should only be allowed to choose the unlocking tool they 'paid' for. i.e. if they completed an offer for the price of a Blackberry unlock code (which is quite cheap for me), I don't want them to be able to get an unlock code for a Samsung phone instead which costs me $20. I am thinking that I will type in the tool from GSMUnlockStore's page which I want them to complete, and they will not have a chance to unlock anything else... only what I put in TrialPay's "Internal Product ID" slot. I hope I'm not too confusing. This is a relist as the previous winner of this did not reply to my emails. I hope whoever wins this will be more dedicated. Let me know if you have any questions at all! Adam