landing page for cell + facebook

Build and design a mobile landing page + facebook landing page * Mobile: This page will host on my web server (apache?) All source code will deliver to me Should look good on all smart phone (IOS, android and win Mobile) The page is a 2 step lead form for USA user Step 1 (page 1): Logo, Some text, and form: • From zip (can enter 5 dig or open a zip code finder) • To state (chose from all US states) • To city (chose from all cities in the chosen state • Date (chose upcoming date) • Size (chose from 6 options) • Check box – specials (yes/no) Next Button (check validation for all fields and go to step 2, if not valid show the r Step 2: Contact info: • Name • e-mail • phone num • comment Submit button, (make a validate check) ? its need to integrate to an existing php form that start a script using the info from the form, the integration will probably be a post commend or open a script ** Facebook should be the same but in 1 form ( not 2 steps) on a dedicated Facebook landing page