Build a website\landing page

I require a 1 page website (landing page) to be created. I like the design of the following website www[.]debtcentres[.]co.[.]uk and would like it to be based upon that. I need the following: A logo created A form and picture created like the one in the above website. The form should submit to email. The design of the site should be similar to the example I've given above but all of the graphics should be changed and style should be different. All headers should be optimised and correct tags used. This is an urgent requirement. Thanks.