Hi,
I have gone through your requirement. I can do the required form using PHP and mysql, however, I have some queries regarding the data.
If you have all bank details in your table i can do it straight away.
if not i will try to get the details of the branches from other sites to fill. -- in this case i am not 100% sure about the completion of task.
please let me know how the data need to be retrieved.
Thankyou
Regards.