Attractive web site with Airfare Request Form

We are looking for a travel website where end user can come and fill out short Airfare Request Form and we can get the information to multiple email addresses. We have following sites that we liked. <[login to view URL]> <[login to view URL]> <[login to view URL]> For logo we like this site <[login to view URL]> On the Home page we would like to have: 1) Request Form 2) Small Banners place 3) Small place where we can put text 4) Decent and attractive logos 5) We do not want flash pages We are open to any suggestions. Thanks, Prashant