Enquiry form for lead generation website

Hi

I need a simple enquiry/call back request form for my Accountantcy website to match the style and colour scheme. It is to go on the left hand side under the telephone number.The format needs to be simple html/css that I can paste in and a PHP file I can upload to the website. The form needs to be emailed to two email addresses. Once the enquiry has been sent there needs to be a redirect to a thank you page. I already have a form but it is not styled and I need to make the form stand out and be as effective visually as possible.

The fields required are :

Name
Contact number
Email Address
Best time to call drop down box (9-12,12-3,3-6)
Radio Button horizontal (New Start Up,Established Business)

If possible fields being mandatory so form can't be submitted without being fully completed. No capita required at this stage.

If anyone has any experience regarding the most effective forms for lead generation websites happy to take advise but otherwise looking for a nice looking form as per above.

Many thanks

David