Create Opt-in landing page template

I am looking for someone who has strong graphical and web design skills to create an opt-in (squeeze) page for me. I'd like it to be similar to: [login to view URL] [login to view URL] If you had previous experience designing opt-in pages that would be a major plus. - Design will include a graphical banner which will point to the opt-in box with free report - layout for some content - I like the template to easily be adjustable for different promotional offer ie.. change banner, page background, etc. - any additional suggestions you have would be appreciated. Thanks, Rich