Need a Wordpress/MailChimp/Mobile Responsive Developer to implement sign up form page

General information for the website: Blog and Mobile App
Kind of development: Customization of existing website
Num. of web pages/modules: 2
Description of requirements/features: I need to convert a photoshop designed sign up form into html and then link it to a new list in mailchimp which will capture the user data.

There are two PSD versions of the form, one is for mobile in long portrait layout and one for desktop so the form needs to be responsive depending on the device or monitor you are looking at it from.

We also have our own location list which has an api and just needs to be connected to the location field on the form so when the user types a postcode it shows an auto complete drop menu to choose a location from (we already have this functionality on our website so it just needs to be hooked up to this form).

There is also a " Like us on facebook " link on the form which needs to be integrated with our Facebook page.

If this job goes well I am looking to implement a mobile theme for my wordpress site so the ideal candidate would have good experience of styling and themeing for wordpress too.
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