Colorful Lead-Gen Landing Page (php)

I need a single, eye-catching landing page built to do one thing exceptionally well: collect leads. The form will ask only for a visitor’s name and email, then route that information straight to my chosen email list or inbox—whatever is simplest for fast follow-up... (Budget: $30 - $250 USD, Jobs: CSS, Email Marketing, HTML, Lead Generation, PHP, Web Design, Web Development, Website Design)