Support form

Hi, I need a ric text contact form with a capch and an upload feature created please the upload will be an attachment to the email sent. I would like nice css turquoise gradient style for the fields.. on white background please.. I want the form to send me their ip address, their os, their host, their browser and country please. It needs to have a thank you on submit function, just a simple thank you page.. I will adjust the template. thanks!