Custom Market Research Web Form

I’ve just launched a small site purchased through GoDaddy and I need a polished form that will power a short market-research survey. Because I’m not entirely sure what sits under the hood—GoDaddy could... (Budget: $15 - $25 AUD, Jobs: CSS, Geographical Information System (GIS), GoDaddy, HTML, JavaScript, Mobile Development, MySQL, PHP, Web Design, Web Development)