You'd need to scan the document as a picture, then insert this into a Word
document, in the header/footer area. Word will likely resize it to fit within
the margins, so you need to restore it to full size, and make sure it's
formatted "Behind the text".
Close the header/footer view, then use tables and frames to position form
fields (from the Forms toolbar) where you want to fill in information.
You'll find more information on how to create such online forms at www.mousetrax.com
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