Creative single web page design with contact form

I am looking for someone that can produce an excellent, creative, eye-catching contact form that will encourage users to complete and submit the form. I am really not happy with my current contact form and I think it needs completely redesigning. Current contact form: [login to view URL] • The contact form must be obvious that it is an Australian company and include Sydney • It has to be eye-catching If I am not happy with the design then I reserve the right to re-post the project and find someone else. Thank you.