PHP or Ruby & Ajax Contact Form

Avg Bid (USD)
Project Budget (USD)
$30 - $250

Project Description:
I need a contact form that goes beyond the traditional definition of a contact form.

Here's what it needs to do:

** Store the messages in a database for future reference.

** Detect all the info you can, like referral, the IP from the sender, the browser and OS

** Use the IP address to determine the country of the sender (using a
geo ip database)

** Add a checkbox asking if people would like to subscribe to the newsletter.

** Detect certain keywords and send an auto response message that can be based on that word. For example if a message contains the word "Red Widgets" the auto responder will say something like "Thank you for your query. For more information about Red Widgets, follow this link"

** Add a filter to block all the incoming emails filled with spam URLs and spam words, which can be defined.

** SECURITY - Form must be secure against things like code injection attacks. Filter out html, php etc from being submitted in the form.

** Ajax - The form should submit and do a refresh all on the same page. Nice and slick. When someone enters an email address in the email form, the ajax should check the email address on the fly for validity.

** There will be a few fields. Name, Email, Drop-down box with "Advertising, Report a bug, Media Inquiries, General Information"

That should be all for now, but some requirements may change. Code should be well commented for easy editing later on.

Skills required:
AJAX, PHP, Ruby on Rails
About the employer:
Public Clarification Board
Bids are hidden by the project creator. Log in as the employer to view bids or to bid on this project.
You will not be able to bid on this project if you are not qualified in one of the job categories. To see your qualifications click here.