help me with a one page site real quick

Ok essentially, im looking to put up a one page website while planning a bigger and better one. It is basically the simplest website possible with like 3 pages to it. Ive made a few as simple as the one I want to make I just need someone to help me out today. Heres what I need you for.... I need a form like this one here ([login to view URL]) with more areas for input. This is a script that sends a form via email to me. I want something like this modified to have about 20 inputs and for the form still to work in the same way. Basically I need the script send to me with info on how to install it. I made the above site [login to view URL] and this is basically the type of site im looking to make today. I have a header pic ready that needs some flash sparkles added to it, which i have the sparkle file i like i can send so that should be easy. Im looking for someone to do this quick and cheaply sometime today. I can provide all info and be available while you work.