create small 'missing cat poster' website

I need a coder to write a small web app (or series of webpages) that will allow visitors to create a poster for their missing pet. The final poster should look like this - <[login to view URL]>. Visitors should be able to upload their cat image, name, age, breed, area, and contact details. This should all be automatically formatted and displayed as the attached example. Your comments, ideas, etc are welcome on the best way for this to work!