As I have checked you want a simple app with few buttons which will include functionality to auto fill form and it will redirect to your website.I will try to give my best if you will hire me.
Relevant Skills and Experience
I have 4.5 years of experience with Asp.net . I have worked with visual studio 2010,2012,2013,2015,2017 .
Stay tuned, I'm is still working on this proposal.