Design 1 Page CSS Template

For someone who designs websites usings CSS, I need a website page similar to the one at this website address: [[login to view URL]][1] It has to be an .html page if possible instead of an ASP page. I want the same similar design as this page, without using the identical code from this site.? It's important not to steal their code!!! I need the following features added to the page: 1. Be able to change the background colors of the website at the TOP of the page. 2. Have a banner at the top of the page, like they have. 3. Have the middle section WHITE. 4. Have an opt-in box exactly like they have with the grey shadowing. 5. Tie the Opt-In box into an [login to view URL] autoresponder.? I want to ask for the NAME, EMAIL ADDRESS & Phone Number - and store all that information as well as storing a tracking code assigned at the the TOP OF THE PAGE WITH THE COLORS into [login to view URL] 6. Leave everything else on the page identical to the way it is, with the exception of the AS SEEN ON box.? I will tell you what logos to put in that box. 7. Leave the bottom links on the bottom of the page to the various links, copyright notice, privacy policies, etc.. That's it.? It should be a very fast page to make.? I would like to have it made as soon as possible!!!