I need a auto loan credit application for my website , example of what i need is http://www.ez-autoloans.com

I need it to be able to add the info from the first page :
name address city state zip code to the next page which would be the full credit application and when the submit button has been click'd on, a splash page would say search lenders in your area.... then the next page would fill in the name address city state and zip, and would say congrats... we have found several lenders in your area please fill out the rest of the application to get your approval... something to that sort..

thank you Spiro G.