New landing page wanted for CarsAuthority.com

Cars Authority

We target consumers searching for problems related to common auto problems and repairs, and try to generate leads for an extended car warranty service.

No

The Title and heading H1 are dynamic, they are generated based on the keyword being searched by the user.
The sales copy will also be dynamic based on the search term.
I'm attaching a rough layout of an idea I had for a potential flow for the site.

Here are the features I'm looking for. Emphasis should be heavily placed on getting the user to complete the actions in steps 1 and 2.

1. Heading with an image slider on the left, a lead form on the right.
Images should be related to auto repair, lead form will request the following info (not in any particular order): name, zip code, year make and model of vehicle, e-mail address, description of mechanical problem.

2. Below the heading, sales copy and call to action. This sales copy will link to an external site (3rd party CPA offer), which will either move the user to a new site or show up in a modal window as an iframe.

3. Below that, a widget showing products on Amazon.com related to their search term.

4. Below this, testimonials. Headshots and some boilerplate testimonials about how much money they saved by signing up for a 3rd party auto warranty

5. Below this, misc. links related to their search (repair guides, manufacturer website, footer)

I'm attaching a (very) rough sketch of one idea I had for the layout, as well as a concept I liked for the header (screenshot of another site). let me know if you have any questions.