Design, Develop 1 static webpage with sign up form

Hello - I need a fantastic static page designed and set up that includes a sign up form. I have recently launched an e-commerce website www.kukucloset.com. I need a separate static page designed with a sign up form for customers to sign up for $10 Free Gift Card that they can use in my store for purchase. Idea is to basically, have this page exclusively for potentials and interested people to sign up and receive a $10 free gift card to shop with my e-commerce website. The page will need to be excellent looking, have great image of real gift card image with my site logo etc... I'm sure you know what is needed (as i don't)...The site should be designed to entice customers to sign up for the gift card...(no credit card info) but just simple sign up (with name and email address), check box for terms and conditions and receiving offers from us etc. If you can create the 1 page SEO content too including linking to my website or write content that makes potential customers sign up, that would be great. I need this done ASAP. Thanks. I know this is not phenomenal work. But I would possibly re-use this resource almost every quarter if not every month to keep running campaigns and potentially other marketing efforts etc. Thanks.