contact form with captcha

need **clean programming** for a contact form which has a background and the fields in the color of the background so they won't be visible, having this features: 1) captcha script, the box should have white border and size like shown in the script. i need the script to work perfectly and to be 100% secure 2) the form should look exactly like shown in the sample above. for the coder will be simple to have it done because the whole form design will be used as background for a div (or something like that - no table). the border of the fields will be #EAEAEA (same color with the fields i designed) so that the borders of the actual fields won't be visible. the background is provided in the attachment. 3) the send button will be delimited with a hotspot 4) all fields are mandatory. if any of the fields are left blank, if the phone field doesn't contain numbers and if the mail field doesn't contain @ and . then to return a javascript alert: *Va rugam sa completati corect toate campurile!* 5) each the fields will have by default inside them a gif image that will disappear when clicked so that the user can write the text in the field (gifs for each field are attached). font to be used - arial 6) form data to be sent at two mail addresses i will provide. attached is a .doc where you can find how the form data will appear into the mail. 7) when sending a form, all the mail addresses entered to be saved into a file called *[login to view URL]* saved locally. the mails should be one on each line. the chosen coder will have to mount the working form on a website and also give me the files. they must be easily to edit and used on other websites. that would be all! ***clean programming is a must*** ***we are always seeking for talented programmers to work with so if we will be pleased, you'll have the chance to get another jobs***