virtuemart add on -custom build

I need to add a sign up form for dealers. This sign up form will be same as: [login to view URL] and email to me. 1) On our site [login to view URL], right under view details will be a text: To get 40% off please register here or log in. The “register here” will be linked to the form. The “log in will be linked to [login to view URL] 2) Same for our [login to view URL] This text will go under the Price per unit (piece): $97.99 3) Form will be emailed to me and i will provide email addresses.