OpenCart Newsletter Ajax Form

I am using opencart for my e-commerce store. Using OXY theme [login to view URL] which is based on foundation framework. On the home page I have an image. When someone click on image a Foundation Reveal Modal should appear with email field. I need user entered email stored into database and a confirmation email send to admin. Email address must be validated on client side and server side before getting inserted into database. Modal Form must be submitted with AJAX & on successful database insertion confirmation to user. I need it done within 2-3 hours. FTP details will NOT be given. You have to provide me the code. I will modify the files myself. My budget is between $10 - $15.