PHP/Mysql to create lead capture and delivery script asap

1. Need lead capture php script to integrate into my web design. Leads will be placed in Mysql database on Linux server. 2. Create a csv download option to download leads created by specific date 3. Lead capture form must integrate with getresponse autoresponder. 4. PHP script must be able to use on available filters to prevent fraudulent entries. 5. PHP script must provide detailed statistics in real time of leads in the database. 7. This job must be completed by October 11th, 5:00 pm central standard. 8. Must be able to communicate through Yahoo IM. You must have examples of your work and testimonials to be accepted. There will be on going work for the programmer selected who completes the job in the time allowed.