Freelance Project

I need a “contact us” form created (php, javascript…it doesn’t matter)

It needs to have:
- 7 fields for customer to enter information (name, email, phone, topic, subject, comments and security code)
- some type of captcha (math problem or something else) to prevent spam, phishing, exploitation of script
- email form contents to an email address I provide
- email customer with a thank you email
- has some type of verification so email and phone number are valid
- takes customer to a thank you page after submitting form