contact form and domain check

Hi, I require a contact form with domain check. This should be easy to do in asap since the domain check script is already made, you can resell this script to other bids after is done. All html and a small check domain script is already done, I just need the coder to program the contact form and integrate the domain script. requierements: [login to view URL] form with a thank you page and that sends a html confirmation email. 2. use already done script and make a small change. ## Deliverables 1) Complete and fully-functional working program(s) in executable form as well as complete source code of all work done. 2) Deliverables must be in ready-to-run condition, as follows? (depending on the nature? of the deliverables): a)? For web sites or? other server-side deliverables intended to only ever exist in one place in the Buyer's environment--Deliverables must be installed by the Seller in ready-to-run condition in the Buyer's environment. b) For all others including desktop software or software the buyer intends to distribute: A software? installation package that will install the software in ready-to-run condition on the platform(s) specified in this bid request. 3) All deliverables will be considered "work made for hire" under U.S. Copyright law. Buyer will receive exclusive and complete copyrights to all work purchased. (No GPL, GNU, 3rd party components, etc. unless all copyright ramifications are explained AND AGREED TO by the buyer on the site per the coder's Seller Legal Agreement). ## Platform PHP only will work on linux server.