Form for selecting templates (using PHP or XML)

I have a service on my website in which I allow my potential clients to select a website template design. I currently have this in flash but would like to have it built using either PHP or XML or a combination of the two. Attached is an image which shows how I would like it displayed on my page. Please reference the image for the remaining notes: 1. I want the little thumbnail images at the bottom to be clickable. Once clicked, a larger version of the image will appear in the upper left section and the name of that particular template will appear in the upper right corner. When a person first visits this page, I want the main image in the upper left to be blank with the text (Select A Template Design Below). They can not submit the form without selecting a template. 2. The two drop down selectors that appear below the template name need to change according to the various colors I offer for each design. When a client selects a different theme color or accent color, the main image needs to change accordingly to show what they selected. 3. The browse button will allow them to upload a logo (graphic in either .jpg, .gif, .png, .tif .pdf .ai formats only). This will result in a link in the email I receive so I can click it to view their logo they uploaded on my server. 4. All the fields except for the "Browse Upload Logo Field" are required or they can not submit the form. 5. Once the form is submitted, I will need to receive an email and I would like a confirmation email sent to the client (I will provide the text for this later). NOTE: I do not need any graphics work done. I will provide all the images and graphics needed for this project. You can see a very similar working example of this in flash by going here.. [login to view URL] I would prefer to have an XML file used for this so I can add additional templates in the future easily. Please do not leave a blank bid amount because I will simply hide it from my list.