Artwork for website banner + "Contact Us" website form

I have a website hosted by [login to view URL] whom utilise parrallels sitebuilder software. The website is using a standard template from the sitebuilder software. What I require is the following: 1. a custom banner for my website, and; 2. a script/ html code for insertion as a "Contact Us" form. Website Banner The website (image of which is attached), has a dark green colour theme, with a default banner designed to blend in with the dark green theme. The banner should consist of (a) a city skyline background, in monocolour with a green hue, and (b) in the foreground of the banner, would be a personal picture (attached) that is in monochrome and has been hard-etched - this image should also be edited to have a green theme and blend in with the banner and website, but be in front of the skyline. The city skyline (which the designer should source) must not be subject to copyright. The end product would be similar in nature to the default banner which blends into the website background, although it should be wider than the default which is quite narrow. Contact Us Form This form is designed to avoid the need to publish an email address on the internet. The form should allow a customer to provide their name (mandatory), email address (mandatory), country of residence (mandatory via drop-down list), phone number with country code (optional), and message (mandatory), with a send button. Once a message is sent, the sender should receive a message confirming "Thank you for your message - we will respond within 24 hours." The format of the form should be in a consistent and similar theme (font type, size and colours) to the website. The destination email address of the form should be easy for me to maintain/ edit. The successful bidder will be granted full access to the hosted website to upload and edit both the banner and Contact Us Form. Kind regards, barranjoey