Looking for a form plugin

Hi all,

I’m looking for a plugin that allows users to fill in a form, and lets them decide to what page they want it uploaded to.

It should look something like this (sorry if you cant read it, its dutch, I couldn’t find a better example because I’m reworking their website) http://i.imgur.com/YSgGiHo.png

Basically the user should be able to upload a new item to a page (lost, found, spare, offered, success)

Thanks in advance