It's certainly possible. This looks like a very basic database (or flatfile for any Halojoys in the audience) application. Any decent programmer could put it together for you in a modest amount of time.
I have a feeling that most contributors to this board would fall into that category and would tend to create this application rather than looking for a script. If you haven't found a suitable script by searching the archives and repositories yourself, you may need to consider a custom job.
