Landing Page Script

I'm looking for a way to segment visitors to landing pages on my web sites. I would like a capture basic details from visitors to a landing page, then send them to a specific web page, depending on what options they chose AND sign them up to an autoresponder specific to the option they choose. So for example, if someone came to a landing page about musical instruments the name capture section may look like this. Name: [free text] * required Email: [valid email] *required Type of Instrument: [free text, radio or drop down] *required - (eg: drums, trumpet, piano, etc) Level of Experience: [radio or dropdown] *optional - (eg: beginner, intermediate, advanced, etc) On submission they would be signed up to an autoresponder specific to the "Level of Experience" they had chosen AND be forwarded to a web page specific to the "Level of Experience" they had chosen. I also want to insert field info into the web page they are forwarded to. If one of the fields has been left blank then I would like to be able to display some text instead. EG, if someone entered: Name: [Richard] Email: [name(at)[login to view URL]] Level of Experience: [beginner] Type of Instrument: [trumpet] They would be signed up to the "beginner" autoresponder and sent to the "beginner" web page. The "[beginner] web page" may have copy that said: "Welcome [Richard], as a beginner you'll get the most from your [trumpet]..." If the person had NOT selected their "Type of Instrument" the copy may read: "Welcome [Richard], as a beginner you'll get the most from your [instrument]..." ("instrument" is inserted because no value was chosen for the instrument played). I'm guessing that this will be a php script but as a beginner I would not like to tell the experienced how best to achieve this project. I have no idea what a fair price for this project is so leave this up to you. I also need a time scale as well. Please contact me if you need any more information. I look forward to hearing from you. Regards Richard ## 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 I'm on cpanel hosting and use either Aweber or 1shoppingcart for my auto responders. Below if info about the server I'm on: Operating system Linux Service Status Click to View Kernel version 2.6.17.11-grsechg Machine Type i686 Apache version 1.3.37 (Unix) PERL version 5.8.7 Path to PERL /usr/bin/perl Path to sendmail /usr/sbin/sendmail Installed Perl Modules Click to View PHP version 4.4.4 MySQL version 4.1.21-standard cPanel Build 10.9.0-RELEASE 118 Theme cPanel X v2.6.0 Sorry if the specification is not great but I'm a marketer rather than a programmer ;o)