Employment Form Creation PHP/pdflib(repost)

We need a PHP Form with Validation on Fields and Dynamic PDF Generation. See the attached form. We need a Form EXACTLY like this in PHP. The PHP Code needs to be separated from the HTML markup and needs to handle the PDF generation in the Post from the HTML Page. we need you to use [login to view URL] for the PDF generation. After compiling the PDF, we need you to attach it to an email and send it to a specified email address.