521303 PHP help with custom WP header and form to email page

Hello all :) 2 quick (I hope) jobs that I need done today. I have been looking at this all morning and can't figure out. First, I simply need to make my WP header look EXACTLY like my website header, this includes the main navigation and image area. The website design is at [login to view URL] The attached screenshot will show you the header we need on the WP TwentyEleven theme. (This is strictly a basic blog - no pages. Just posts by category.) Second, I have a form at [login to view URL] that needs completion. All design is done. Just need this form to be sent to me via email. Need validation and some form of CAPTCHA to prevent spam. This email will come to us and we should be able to hit the reply button in the email to respond to them. Looking to pick someone within the next hour or so. Thanks, Rob