Create an online form to capture details on my homepage
$30-250 USD
Completed
Posted over 12 years ago
$30-250 USD
Paid on delivery
I need someone to create an online form which captures the details of people who visit my website.
I have not launched my website yet, there is only a blog posted on it for SEO purposes, but I have some marketing going out in the newspapers, and I want to be able to capture the details of website visitors, and also direct them to the facebook fan page.
I have the design of the website which I can provide. I want the same elements used.
It needs to ask them if they are a Customer or Driver
First Name
Surname
Mobile number
Email
Password
Where did you hear about us (pulldown menu with a few responses)
Agree to terms and conditions box.
I want it up in 2 days.
Only quote if you have good feedback.
Hi,
I can make the form in 1 day with all the validations aswell. Just finished a form for www.dropmagic.com. This too is just to capture details , the website is not up designed yet. You can visit my portfolio at www.mywebdesignz.com.
Regards,
Gaurav
Hi, I've been working as a web developer for more than 3years now ,and i've Proficiency in working with AJAX, PHP,MySQL,Javascript,HTML,CSS . I know i can deliver what you need. Please check PM for more info.