How to create a simple input form in BPC 10.0 and the details are below

Hi Experts,
I would like to know how to create attached input form and what are the dimension would require to use in order to populate correct report
Please provide your comments and the sample report has been attached.
MGA Index
Column
Head Count Planning Required
Approver authority
Asset
Row_Cost Center
Business Development
Finance
Procurement -
  C&P
Legal
HSS &  Environment
Petroleum Engg
Drilling
Subsurface
Thanks in advance.
Regards,
SK.

Hello,
The new update of Muse allows you to use the Webforms widget with a non Business Catalyst host as well.
However, Captcha is something which currently cannot be used via Muse without using Business Catalyst as host.
This document might be of some help : http://forums.adobe.com/docs/DOC-3581
Regards,
Sachin

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