43701 phplist config job

I need someone who is able to make a custom signup screen for a newsletter and we are using phplist. This is for a foundation for children with a handicap ([login to view URL]). Your job is to: - build a signup screen for the website with the following attributes. + Name + Lastname + City (also a check if the fields are not empty AND a valid email address) You have to configure phplist (already installed on server) for this newsletter. Phplist should register these values into his database and will sent a confirmation mail to the user to confirm his newsletter membership. After confimation from the member he/she will be member of this newsletter. Also some small configuration changes should be made to the phplist configuration.