I need some extreme help with making a quiz in HTML. My point is to have a HTML page on the web that people can visit, fill in a quiz, and the data will be stored. Now, I have no knowledge what so ever about how to do this, all I know is what I need to do. I understand that I'm pretty much asking you guys to do the heavy lifting for me, but I need to do this for tomorrow and I can't simply learn everything in a few hours. I've tried to do some stuff, but didn't really work out. So, if you are willing to do the programming for me, here is what I need:

* A form that asks the user for his age (he inputs the number equivalent to his age);
* a multiple choice form that asks the user if he is male or female (maybe even a dropdown menu, either of them are fine);
* a multiple choice form that asks the user how much time he spends on pc, the choices being: 0-2 hours, 2-4, 4-8, 8-12, and +12 hours.

Again, usually I would be trying to learn HTML from scratch and doing this on my own, but I need to do this as fast as humanly possible, so if one of you HTML/javascript programmers can give me a hand, I would much appreciate it. I have a free subdomain on freehostingeu.com where I can host the HTML. Also, I would like to be able to store the choices of the user so I can analyze them afterwards.

PS: I am not used to posting here, so sorry if I'm doing something wrong, you can always mention it on your reply. If I'm forgetting to mention something important, tell me so I can add it in as well. 

Thanks in advance.