Hjælp til formmail script

Jeg søger hjælp (en programmør) til at udarbejde et script til at håndtere en form som så skal generere e-mail.

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Kravene jeg har fået er flg.:
1) Picture code field  (eg a 4 letter string within a picture, hard to automatically analyze by robots) which needs to be filed by customer / sender
2) Form fields send from e-mail adress, first name, last name, message, recipient e-mail adress
3) Only one sender + 1 recipient e-mail adress allowed
4) A perl module should be used for mail sending which does not use the commandline /usr/lib/sendmail -n -t (there are various)
5) Check if valid e-mail adresses provided, the following module should be used: http://search.cpan.org/~rjbs/Email-Valid-0.179/lib/Email/Valid.pm
6) Restrict firstname, lastname fields to common latin characters in German, Spanish, English, Italian, Dutch, Danish, Swedish, Norwegian, French, Finish, Russian, Serbo-croat, turkish (well everything except certain ranges from UTF-8)
7) Check Message field against a blacklist of words / attacks (viagra, cross site scripting...)
8) Check that no other URL is within the message
9) Check referrer of page to be domain it is on itself
10) Simple html page (separated) containing the form
11) Included in cgi separate pages for success or error message