Mailchimp and Wordpress expert wanted

I need a mailchimp expert who can create a contact form in wordpress with options for: First name Last name Email address 4 check box options Submit button This will need integrating with mailchimp to create 4 email lists. The details will populate a list depending on which of the 4 check box options was selected. For example if a user selects 2 of the check boxes then they will be entered into 2 lists. I then need automation to be setup so that the user immediately receives an email in their inbox when they subscribe to a list. For example, if they subscribe to 1 list they will receive 1 automatic email, if they subscribe to 3 lists they will receive 3 automatic emails. I will need 5 versions of the form setup. One with no checkboxes ticked by default and one each with each of the checkboxes ticked by default.