Sample request form and database options

I have a site that offers a free sample of our product. Currently someone fills out the form and it is written to a sql database on another server. We are going to launch a new site and was wondering if there are any online options through a 3rd party provider that can handle sample requests and allow us to do searches for marketing, such as a chart showing age ranges or a map showing where people requests samples from.

I also want to get away from the single sql database that could go down more easily than a cloud solution.

THanks so much.
BiofilmincAsked:
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lenamtlCommented:
Hi,

I'm using Jotform www.jotform.com which is very flexible
This can be use as basic form or  can be push to more complex needs.

http://apps.jotform.com/category/analytics_and_reporting

Plus there is an API and tons of cools features
http://api.jotform.com/docs/
http://apps.jotform.com/
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