Signup Page Redirect with a twist

I will be referencing two websites in this post. Please excuse the length and I appreciate you helping this newbie out.

The first site is the site I just created. https://www.mca80dollarcommissions.com, herein after referred to MCA SITE.

The second site, https://www.tvcmatrix.com/roadmaptofreedom, hereinafter referred to TVC SITE, is a self replicated website that each new member gets when they sign up for the MCA Motor Club of America Plans.

We will be doing conference/training calls, where existing members can invite new prospects to the call to learn about products and compensation and training. We will then send them back to the person that referred them to the call so they can sign them up and get the credit through their own website. If, for example, someone hands out business cards with the referral name on the card, and they come to our MCA site, I want to redirect them through the join now page to the referrers website, where they could just enter that referral name and our Join Now Page would redirect them to persons site that referred them. If they were not referred by anyone, and just came to the site through facebook, our You Tube, or Twitter, etc., then I want the default redirect to be to the https://www.tvcmatrix.com/roadmaptofreedom website.

On the MCA Site, I have Join Now Page, where I want to place a sign up box with the following.

First Name: “FirstNameBox” Last Name: “LastNameBox”
Email Address: “EmailAddressBox” Email must be the same email address you used to join MCA Motor.
TVC Matrix Promotional Link “TVCMATRIX.COM/{PROMOTIONAL LINK}BOX
DATE YOU JOINED “MonthDayYearBox”

I also want to capture that information in case they don’t sign up at that time, so that we can have then on our mailing list. I am using listwire.

Any ideas. I’ve searched for a plugin that would accomplish what I am trying to do. Maybe, I’m just making this to difficult.

Thanks
Paul Staples