Sequential autoresponder for Prospects

I mean a lite Autoresponder. No import of leads or other crazy features. Just the ability to setup a campaign, and capture the Affiliate ID info from the Squeeze Page / Landing Promotional Page, or an Info Request Page Form so as to include the Affiliate ID as a tag to be appended to a field in the emails.

Example: I visited www.domain.com/Affiliate1 page and filled a form. The form should capture on a hidden field the Affiliate ID and send it to the autoresponder as a Tag so that in the emails it can added to: visit site www.domain.com/TagOfAffiliateID to visit the site for more info.