Secure web form with hosting?

[[L]imey]

Hey guys,

Trying to figure out how to accomplish something for work (I work for a small municipality). Essentially, I need a single page web site, with customizable fill-in fields, some simple validation (all fields required kind of thing), and then storage of the responses on the backend, that can be exported to csv or excel or whatever.

I've never had to look for something like this, so my google-fu is not returning the responses I'm after.

Basically we'll be mailing customers a letter, telling them to go fill out this form, we want them to populate the values, and then have the website host store the data for us so we can export it and use it in our system.

Does that make sense? We're dealing with federal ID numbers and social security numbers, so we need whatever standard security is for this information type (i'm not up to date on what's required here)

Thoughts? Ideas? Businesses you know that provide this type of service?

 

[cwaffles]

Minimum is SSL/TLS security, and some good security hardening from the hosting company.

I would use Google Docs for forms if you're on a shoestring budget, or give Wooforms a try (heard they're good, but haven't used it for myself - http://www.wufoo.com/)