Need simple customization of Dolphin site

Hi there,
I have a page livingfoodsingles.com that I am looking to customize. I am looking to add the following fields to the joining form:

birthdate
location, city, zip/postcode
type of diet: drop down box choices (to be given later)
type of raw diet: drop down box choices (to be given later)
favourite raw foods
wants children/has children
description
occupation
income
height/weight
build
hair color
eye color
hobbies
favourite books
spiritual practices or religion?
favourite movies
relationship status:drop down box choices (to be given later)
idea of a fun date
I like to talk about
My friends describe me as
Drinking?drop down box choices (to be given later)
Smoking? drop down box choices (to be given later)
Reasons for raw diet/vegan diet
Looking for:
-gender
-romance/friendship?
-wants children/has children?
-ideal mate description
-what is the one thing that is the difference that makes the difference in making your ideal mate stand out?
-diet of ideal mate
-height/weight of ideal mate
-build of ideal mate
-eye colour of ideal mate

I also want people to be able to search in the following fields:
age
location, city, zip/postcode
type of diet:
type of raw diet
wants children/has children
description
occupation
income
height/weight
build
hair color
eye color
hobbies
favourite books
spiritual practices or religion?
favourite movies
relationship status
Drinking
Smoking

I may add or subtract, but it will be approximately the same. I also need a basic header graphic design. Coulud you send me an approximate quote with breakdowns for this job? Please let me know if you need further specifics.

Thank you!

Hanan Zarour, B.Mngt.
The Success and Transformation Coach
Effortless Brilliance Coaching and Consulting
www.effortlessbrilliance.com