2 Page Web w/ Form

Hello- I am seeking to hire a person who is moderately skilled in both programming and design. This is a simple web-template with only one form to create that will take information from a registrant, and copy me in an email notice. There is no admin area, no backend, very simple in structure. Index page w/Header (flash intro header may be nice) Sub-page form. Sub-page template for me to write content on. If you can create the site in colors Orange, Blue, with other accents, also using White/off-white. This is for the Reality Television Industry, so it should feel polished and dynamic. The header area would have some images to be included that I am attaching, and use the logo/site title: [login to view URL] I'll need to still create a sub-title/tagline. There will be tabs along the top of the main page area with links for "Enter Your Reality TV Idea", "Prizes", "Pitching Reality", and "How It Works". Please provide any mock-up, or sample work for consideration. I also provide bonus for good completion.