Create username and email database and help box on webpage

I'm looking for a website developer that can create a registration form with email and username.

This information will be part of a license key on indicators and EAs sold on that website. However there will be a new job created for this stage.

For now I just need a registration box with email and user name to be input by the user. A list or database of this information to be created.

There should also be a help chat box for users to leave messages on.