show a interestial image with suscription box on wordpress

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

Project Description:
i have a simple task

1) I'm creating a promo for my site and i need to show an interestial picture with links and a suscription box

The user will click on it, see every option and choose what he wants

then he will add his data , confirm he wants to participate and subscribe... then show a confirmation message

The e--ma--il collected goes to feedburner, if you can hide the capcha from feedburner and show like it comes from my own site.. better

BTW the interestial ads will be shown only once per visitor and i need to have the option to ban some countries to see this ad.

2) Fix my rss to show the pictures from the articles

Skills required:
Graphic Design, HTML, PHP, Website Design
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