Write some software

I need you to develop some software for me. I would like this software to be developed for Windows . Make a simple but nice looking mailing list signup app that runs on an android (essentially like a google forms DIY mailing list w data fields for name, email, checkbox to a few questions like "where did you hear about us) but has the capability of taking the submissions when there is no reception and not rely on internet connectivity to work. It would have the functionality of a batch upload at the end of the day, when we can get to a spot with good connection or wifi- ideally to a google forms or some database. This is for people (like me and some of my team members) to use at work when not connected to the internet/no data signal, like at work events or sales floor in buildings w bad cell signal and no wifi, and need to collect people's info. This is the alternative to asking people to give their info manually or on a paper form that has to be manually typed in a spreadsheet later.