You should probably start by breaking these requirements down into steps assuming you will be doing the work yourself.
1. PHP page to collect user data
2. Store collected data into a databse
3. PHP page to display user data
Then investigate each step and google tutorials on how to start programming in PHP/MySQL/CSS/HTML - Bring any questions you have back here to the appropriate forum.
Bugs that go away by themselves come back by themselves
Beware - your loyalty will not be rewarded