Develop A Custom Online Assessment

I am in urgent need of someone who can create a custom online assessment to be displayed on a current Wordpress site. A javascript quiz would do the trick. There are 18 questions and 6 categories...Each question is worth 3 points and the final results page needs to display the score for each of the six categories. I've attached a word document with an overview of this assessment. Here's something else I need...In addition to displaying the results, the user will also enter their email to access the results and get a copy emailed to them as well. We are using Aweber for our lists and I need to know if it is possible to integrate that into this as well. The format needs to be current, mobile friendly, and have the same styling as some of the quizzes you find on Buzzfeed with social share options at the bottom of the results. Please let me know if you can get this done in just a few days and send some examples of your work. Thanks!!!