HTML Lead Capture Page

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

Project Description:
Im looking for somebody that is available all the time, that can build me simple lead capture pages, and other simple various HTML pages.. No wordpress, straight HTML. Let me know. Each one of these pages will be configured with Infusionsoft. I have the simple form code for that. You can see it here:

This is a sample of a page I need built right now:

Skills required:
Graphic Design, HTML, PHP, Website Design
About the employer:
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