388291 Pop up form

We have a page at [login to view URL] that we would like to integrate a pop-up form in a similar style if you select the more link at [login to view URL] in the first paragraph. The form would need to activate through a button that we will design and provide. The form needs to contain the fields below: First Name: Last Name; Email: Phone Number; Services Needed: - Organization/Relocation/Lifestyle - Project Services/Renovations - I require both services Comments: The form will need to have an auto thank you response email sent from our website that we will design after you implement a .html file on the server. Also the form inquiry will need to be email to [login to view URL] however in case Organization/Relocation/Lifestyle is selected then the form would need to be cc'd to [login to view URL] and in the case Project Services/Renovations is selected then it would need to be cc'd to [login to view URL] In the case of "I require both services then email should only be sent to [login to view URL] Looking to complete his asap.