replicated lead capture page system and follow up autoresponder

I need a replicated lead capture page system. One that can replicate a lead capture page plus have automated follow up messages. The system will also need a members area to track each persons leads (in a lead list) and visitor stats to their capture page.I would also like a banners area where members can select banners to use for online advertising. This software already exists I just need one that can be customised and has the source code. I just need someone that has one already developed that can be setup for my site. I have an attached sample of a system that I currently have. I would like to also be able to reinstall the script (for other sites i design later) once I design the members area the way I want it customised.