505000 Simple form in Wordpress

Hi I would like to have a simple form installed in wordpress I would like the form to look like this one [login to view URL] All the wording can remain the same. I would like to use the cformsii plugin in wordpress ideally but it can be an other way. I prefer cformII because it's easy to change. If you have better plugin I'm open to that. my wordpress website is here [login to view URL] please be available on skype for easy communcation use keyword 'hollar" when bidding and messaging.