I've recreated the page as close to the design as possible.
I wasn't able to create the "Skill Level" part of the design, also I don't know how well it would look based on the current size of the form
I wanted to inquire about the text colour, for example, the "Notes" section on the design is white, however when I coded that in, it didn't look that good as it felt there was too much of the same colour on the form so I decided to leave it as black
I've recreated the page as close to the design as possible.