Order Form in shopping cart with few fields.

Hi.

I am using nopC with DefaulClean theme.

I need a kind of contact form in cart with some fields like Name, E-mail, Phone Number, and some other fields. Registration on the site is not required. All data and products added to the cart should be sent to admin's email address. It is not necessary integrating orders in admin panel. Submitted contact form will be sent just to the admin's email address. That's all. The admin has to see products added to the shopping cart and all names, contacts and so on..

I am looking for a developer who worked and works with nopCommerce. Portfolio is optative.

We may discuss it in details.
Please, contact me in Skype: zafar_12
Or on VK: vk.com/zafar

I am waiting for help.
Thanks.