I have a themeforest template that has most of what you need, you will simply need to modify it.
I used this template [login to view URL]
to make a page. (I will show winner)
The first page form's data (already created) should transfer via cookie/browser (get or post) session to next page.
You will be Creating a form using same general style/layout for the second page (using same css) with 9 fields that will have a 3 fields prepopulated with previous page data.
This should take you less than 1 hour.