Six Page Website For Affiliate Network

I am interested in creating a 6 page life insurance offer to run on an affiliate network. I would like to clone a current life insurance offer running on a competitor’s website. See attached document for the link.

This site needs to be written in a language that will allow insertion of PHP code for the life insurance quote engine I will be using to display life insurance quotes.

Here is what I would like created:

Page 1 – picture of family and child with about 10 fields of data to capture and submit application button

Page 2 – this page will display the top 5 life insurance quotes, need to use the quote engine software that is written in PHP code

Page 3 – another form that collects about 15 fields of information, submit application button

Page 4 – information screen with text

Page 5 – another form that collects about 15 fields of information, and submit information button

Page 6 – information screen with text

Each page will include my company’s logo. I need a nice large graphic for the first page of a mother, father and child. Page 4 will also has a graphic with children. Page 6 will have a graphic with a family.

I would like this offer to be operational by January 1.

Thank you.

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