Lead capture page for Education

We need a lead capture page for our education campaign, this is what we're after: Header/Title would say: EconoEdu College Guidance & Financial Advice Under the title/header we can have a simple description, like this: Are you lost in the college search? Our consultants will help you find the right career for you based on a number of factors: academic and athletic performance, social needs, and of course, your financial situation. We can help you save $15K or more on your college education. We will: *Create a student resume to showcase your strengths and help you find your dream school! *Guide you with Common Application and financial aid forms specific to the college application(s) of your choosing. *Help you complete your FAFSA and establish your HESSA account. Plus much more! ---- I'm thinking the body text can be to the left of the screen on desktop and capture form to the right, and on mobile text above and capture form underneath text. It obviously needs to be mobile responsive. The capture form would be simple: Name Email Phone # Best Time to Call (Mon-Fri & Hours drop down) Here are some examples to guide you, and give you an idea of what kind of design we're looking for: Degree Source Match: [login to view URL] My Degree Resources: [login to view URL] EDU Degree Resources: [login to view URL]