Trying to create an application that will go to a webpage, fillout 4 boxes, submit a captcha, then close the page and restart

I am trying to automate a signup page on google chrome. The chrome URL requires information to be filled in (Name, address, email address, DOB, and few drop down menus as well. At the end of the form there is a captcha that must be submitted prior to submitting the page.

I am very new to this and have spent around 10 hours researching ideas but have made very little progress.