Pop-up Lightbox to Collect Emails - ConstantContact

IN PROGRESS
Bids
10
Avg Bid (USD)
$69
Project Budget (USD)
$30 - $250

Project Description:
We are wishing to add a pop-up lightbox form to a website in order to collect visitor emails.

1 - Lightbox pop-up must only appear after x number of seconds
2 - Form fields will consist of NAME & EMAIL
3 - Form must be able to integrate with ConstantContact
( we have 5 customer lists on ConstantContact split up in regions - UK list, USA list, Europe list etc )
4 - We must be able to specify which list on ConstantContact the name & email are added to
5 - After customer submits details - the confirmation page must appear within the same lightbox window ( i.e.customer must not leave main site ... the redirect to confirmation page must occur within the same lightbox window possibly using iframe ? )

See the below files which demonstrate a rough mock-up of the lightbox pop-up and the confirmation screen after submission


The lightbox design must be super-professional and look good from a graphics perspective ... it should match the design of the rest of the site.
You must have prior experience in a similar project ...

Skills required:
Javascript, Website Design
Additional Files: lightbox1.jpg lightbox2.jpg
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