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Lead Capture Page Needed

I need a solid lead capture page that keeps all leads in a database so I can send e-mails to them periodically. I also want it to send me an e-mail each time a new lead signs up. I would like a nice graphic interface for the page also.

Skills: Internet Marketing, Perl, PHP, Script Install, SEO

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About the Employer:
( 0 reviews ) Centerville, United States

Project ID: #10830

6 freelancers are bidding on average $472 for this job

best1

Dear Sir, We are a team of highly qualified and creative programmers and designers. We have experience developing web-based applications and designing websites. We have read and understood the project requirements an More

$500 USD in 18 days
(186 Reviews)
9.6
Maestros

We can do this and do this efficiently. Please contact us via PMB. Regards, Abhishek

$450 USD in 25 days
(109 Reviews)
8.4
siddhartha1

Dear sir, we can do it as per ur requirement,we have skilled team and we assure you of quality work,pls contact us via pm,thanx

$480 USD in 18 days
(37 Reviews)
7.7
eccentricworld

Hi, we can do this in good manner. we are doing similer lead assignment project for moving company. please see demo here http://www.majorvanlines.com/default.asp . regards sri

$500 USD in 18 days
(68 Reviews)
6.7
viaden

Dear Friend.We got your idea. We can provide you EXACTLY WHAT YOU NEED!!! We have all the required skills to complete your project in the best way, so you can be abolutely sure, that you'll receive a top-quality resul More

$500 USD in 18 days
(4 Reviews)
6.4
bandwidth

Please see PM, Thanks.

$400 USD in 7 days
(16 Reviews)
5.7