Hi,
I can create a Plugin for this, so that will offer you a short code, so you can please anywhere in your content of Wordpress.
Regarding the look and feel, as this is going to work with Wordpress plugin system, all the header footer and side bar will stay like they are, and the form will appear in content area.
Advantages
1. You can just install it like a plugin
2. Can be usable into many wordpress sites
3. Can accomodate any place with shortcode
4. Easy to use and maintain
Please check my profile and let me know if you like my proposal
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Thank you