Find/create Google/other software App that can collect data from website visitors for a specific cause - repost

Hi , I need someone to find/install Google/other software App/code that can collect data from website visitors for a specific cause and these data has the following customizations: 1-They can stored and exported by website admin 2-Visitors can fill form with all data required 3-Based on data , there should be geographic location feature so it shows visitors reports based on their location (either API or based on location entered).those should show on a MAP. 4-easily customizable 5-Can be installed in PHP website Thanks,,