Refer-A-Friend Application

Hello, I am looking for a refer-a-friend script that can be re-used on different websites. I am aware of all the free scripts available so please don't try to sell me those. I need something custom made! Please READ AND UNDERSTAND the main points/features needed before bidding: 1- Ability to use this script on various website/domains. Must be easy for me to modify and setup each time. 2- Ability to choose how many referral boxes the script will use (i.e. On one domain I may want to use only 1 name/email text box, and on another I may want 5) 3- Ability to have a carbon copy sent to the administrator (including the name/email of the person who filled out the form, the names/emails of the people they referred and the message they sent. 4- Ability to change the email address of the administrator who is receiving the carbon copy. Since this script will be used on various websites, the email address will be to change! 5- The script must be customizable "look-wise". In other words, I will need to be able to change the design of the form (change colors, font style, add logo to top etc...) There are two ways to complete this project. A) The first would be to develop an online control panel in which I would fill in certain fields and the system would automatically generate the code for the refer-a-friend script specific to the domain that I am using it for. B) The second option is to just provide me with a script (code) in which I would directly edit everytime I re-use it for another website. I don't know any programming (obviously) but I am pretty good with editing scripts *if* proper instructions and comment tags are included. Please include how you plan on doing this for me (option A, B or something else) and include your total price. I have MUCH more work available!! If you do a good job on this, you will have priority on all my other projects. ** I am setting this at the lowest budget so if you think it will cost more, please include the total price in your bid.**