Need a Visual Basic Program for Data Entry

Here is what I need: I need a Visual Basic Program that allows a user to enter a Customer name, Job Description, and the initials of who entered the information. When that information is submitted, it should be stored in a MySQL database with a "Job Number" automatically generated, in progressing order. In another form, there should be an admin functionality that can take that information and add a "Project Accept" field, "start time", "end time", and "project build number". This should all be saved to a MySQL database to be recalled from any computer and can be written by many computers anywhere within the network. The information should be able to be recalled in the admin form and printed.