In Need of a Single-Field Contact Form

(My first post in the WP.org forums so apologies for any misunderstandings or misuse of the forum)

I am looking for some way to generate a single-field contact form.

Essentially, I want there to be a field into which a site visitor can input their e-mail address, and next to that, a button that says “I’m interested” (referring to their interest in a second pressing of a limited edition music release).

Upon their pressing of the button, I would like the inputted email to somehow end up in a spreadsheet or database in order that I can keep a growing “list” of individuals interested in a second pressing. Even better (but optional) would be to have an area in my dashboard that would update me on new additions to the list.

Does anyone have any tips on how to make this happen? I have fairly solid knowledge of CSS, good knowledge of HTML, and inserting jQuery objects isn’t an issue either. 🙂 PHP is a bit beyond me but I’m willing to learn.

Thanks!
b