Squeeze Page Design Needed

I need a 800x600 squeeze page designed for a website about making money online with white label dating. Basically the design should have text on the left and a auto responder box on the right. Would like auto responder code implemented as well. Also would like all the text on the page to be editable. I will provide text to be used on the page. I have some examples of some plain squeeze pages and some more fancy squeeze pages attached so you can see the layout, the buttons, the arrows, the bulletpoints, the graphics, etc. I want my page to be somewhere in between the plain ones and the fancy ones. I want people to know the site is about making money online when they see the page.