Affiliate expert needed

Hi, we have a site that rents affiliate software to merchants. I would like to add a form (accessed via a menu button on the homepage) where potential affiliates can register with us (as opposed to just registering with one merchant on our site) so that we can keep them informed of new merchants joining us, promotions etc. There will be no charge to the potential affiliate to sign up. They will have to supply basic details only at this stage, such as email address, site URL that sort of thing. Obviously we need to be able to see who these affiliates are within the existing CMS. A small problem has been brought to our attention with the same site, it doesn't display properly in Firefox, so I would like it fixed so that it displays properly in all browsers. I would really like someone who is very experienced in affiliate software for this as we will have lots more work as we develop the site further in the next few weeks. Please PM for further details. Thank you.