Create a Form using Yii

I need a dynamic form created in Yii. It create multiple records in one database table. The form itself will try and fill in as much information as possible for the user based on the other tables within the database. It should be a pretty easy task for a developer with Yii experience and you must have Yii experience. If I like your work on this form, there may be more work available. The attached file gives you a better idea of what I need.