120101 Lead Capture Form

Hi All, I am looking for an intelligent programmer who is experience with PHP/MySql script development to capture all visitors information before sending off site to merchant's signup page The script has to perform the following tasks:- 0/ Create a new campaign for the html form 1/ Generate a html signup form to be put on any of myown sites with input fields correspond to merchant's signup form 2/ Verify the integrity of inputs from visitors 2a/ Check for duplicate enry using email & ip ? of the same campagin 3/ Store all information in the database 3a/ enable/disable Subscription to Aweber with Email & First Name with list information in campaign setting 4/ Post/Map all fields/selected fields to merchant site after clicking the "submit" button 5/ Optional: Check if leave previous site and Direct visitors to another merchants 6/ Direct user to a "thank you " page. Please feel free to bid or ask question when clarifications is needed. thks Sample merchant site [login to view URL]