CasperJS script to submit form for a generic website

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Project Budget (USD)
$30 - $250

Project Description:
Require an automated script written in CasperJS to submit a form for a generic website.
It should be able to: Detect the relevant fields on the page, input dummy data to pass validations in the relevant fields, and submit the form. The script should be generalized to any website where possible. It does not need pass a captcha.

An example contact form that the script must be able to automate is found below:

Please describe briefly how you intend to approach the problem.

Skills required:
CasperJS, Javascript
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