Free webhosting in return for a fairly simple script

I need what seems to be a fairly simple PHP script. I run a paid hosting, as well as free hosting site. I need a script that people can go to and sign up for free hosting. The fields that need to be on the form are:

First Name
Last Name
E-mail address
Subdomain you need
Your Username on the forum
Password

Then I need it to store the users IP address or some other effeciant way to track the user. The reason is it's strictly one account per person. So I need somethin in the script that will check the database (needs to be MySQL) for the IPs of already submitted forms (or whatever is being checked) so we don't don't get jipped by people that sign up for a free account again. It needs to be an IP or something else unique. It can't be e-mail addresses or anything like that since users have multiple e-mail addresses. Then I need the script to check my forum database to make sure the username they signed up for is in my forum's user table. After submitting a need it to e-mail me with details

You do not need to design a template for it, just a form. I'd like to maybe have a form and make the post action point to the PHP script and have it proccess the form data submitted.

For this project completed and working I will give you or your team free hosting for as long as you want. You will get unlimited DBs, FTP, subdomain, e-mail, ext... Space and bandwidth will be negotiated.

A MAJOR plus that will earn you alot more space and bandwidth is if you make it so after the user submits it, the script connects to my WHM (Web Hosting Manager) through a remote access key and sets up the account automatically.

If you think you are up to the challange you can contact me via:
AIM: LiquidBluX
MSN: liquidbluex@liquidbluex.net
Support E-mail: support@liquidbluex.net

Thanks,
Jordan

Anyone? I'm willing to negotiate

Jordan, you may be interested in posting your project on a site such as GeekBidder. It's a very effective way to find someone, or rather let someone find you, and complete your work.

Thanks for the advice, but from what I see, you have to have to pay the bidder.

Possibly.

Though, people may be willing to do it based on your terms. There is nothing that requires you to pay anyone.