Design a Fedora themed interface for the following:

Form Title : Record new financial transaction

1.  Field Name - Trac

1.  Value – FAmSCo, APAC, EMEA, LATAM, NA

2.  Description – This field specify what trac is being used for this record.

2.  Field Name – Ticket number

1.  Value – Integer 1 to 10000

3.  Field Name - Status

1.  Value – New in Trac, Approved in Trac, Reimbursed, Closed, Unapproved, Cancelled

4.  Field Name – Amount

1.  Value – Currency amount with 2 decimal places

2.  Description – The amount will be entered

5.  Field Name – Reported Currency

1.  Value – ISO three letter currency code (include all the ISO currency codes with major currency codes in top)

6.  Field Name – USD Amount

1.  Value - The amount will be entered

7.  Field Name – Paid By

1.  Value –String with max 100 characters

2.  Description - username of the person who has made the payment

8.  Field Name – Expense Type

1.  Value – SWAG production, Event Support, Travel Subsidy, Other

9.  Field Name – Payment Date

1.  Value – currency with two decimal places

10.  Field Name – Reimbursed Date

1.  Value – currency with two decimal places

11.  Field Name – Reimbursed Method

1.  Value – Paypal, Cash, Western Union

12.  Field Name – Reported By

1.  Value – username 100 characters max

2.  Description - username of the person who has requested the fund

13.  Field Name – Remarks

1.  Value – Free text field with unlimited characters

Submit button to submit using POST method.

Submission: When you done upload a screenshot and upload all the code in ZIP file as the final submission. All files should be uploaded to Google-Melange. No extension will be provided.

Refer : http://fedoraproject.org/wiki/GCI_2012/Students_Instructions