Attached is a JPG of what I would like to have made into a webpage. This will be just a single page website "splash page" I have and own all the supporting images and would like to link to an existing video on my youtube account. I am interested in some minor tweaks to the attached image such as more favorable font or any suggestions to make it look better. I would also be interested if someone could make it so that when you click to enter the form it adds 2 more fields: "Address" and "Type of Project" - if that is feasible. I would like the site be be google friendly such as that the text can be selected and the images are individual and have alt tags. The footer will also need links where the text is all caps. I have purchased the domain on godaddy and have hosting through them. I would also like to provide the upload credentials for you to upload and make the site live.
Please respond with DETAILS of how the web page will look and function. Vague bids that just say stuff like "i will do a good job for you" will be ignored. Please include the details of how the site will function, how long it will take, anything I should know or expect. Please also include similar work.