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Write WebForm in JavaScript

I have a WordPress theme which has space in the side-bar for a contact form (see attached image). I need a coder to write a javascript version of this form. The fields are 'message' (text area), name, phone number, email as per the image. The script needs to include a line where I can insert an email address for form completions to be sent to. As well as another line where I can insert a re-direct URL upon form completion. Experienced coders only. Please write the word "javascript" at the top of your proposal so I know you have read through this entire job description. Thanks.

Skills: HTML, Javascript, PHP

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About the Employer:
( 14 reviews ) Sydney, United States

Project ID: #12028427

24 freelancers are bidding on average $132 for this job

rajeshsonisl

Hello! With 98% to 99% completion rate, 900+ successfully completed projects, and a 4.99 reputation (maximum possible, 5.0) (can be verified on my profile page https://www.freelancer.com/u/rajeshsonisl.html !!)... y More

$210 USD in 1 day
(751 Reviews)
8.1
webiglobe

javascript Dear Sir, I am really interested to work on this project . I have very good experience of doing this sort of job, I can start the work now and can assure the best service from my end. I am waiting h More

$160 USD in 3 days
(206 Reviews)
6.9
dghq123

Hi there.. I have read your project details completely and willing to do it for you... Check our recent reviews for our quality work on on time delivery : https://www.freelancer.com/projects/Graphic-Design/Web-develop More

$200 USD in 3 days
(52 Reviews)
6.3
asait1192

"JAVASCRIPT" Hello Sir/Madam, I am Asait from Skynet Global System ,Gujarat. We have team of inhouse team of 15 developers and we have delivered 200 projects within 1.5 year of time span. My Skills: - - >Desig More

$222 USD in 15 days
(26 Reviews)
5.9
BaNgan

javascript Hi, COuld you take a look at this site: http://demo2.dataplayer.biz/001.Order/canteen/canteen001/ You can place the info and the email and a version of the form will be sent to you Do you want the sideb More

$133 USD in 3 days
(101 Reviews)
5.9
$147 USD in 3 days
(87 Reviews)
6.2
sarow471

javascript Hello , I have 5 year experience in web development from last 3 years I am working on wordpress. I am good with theme/plugin creation and customization.I have done work on lot of plugins and premium t More

$55 USD in 3 days
(32 Reviews)
5.9
microwebtechs

A proposal has not yet been provided

$100 USD in 0 days
(85 Reviews)
5.4
yogeshssanwal

Hi there - My name is Jhalak. I’ve read your brief and can see that you’d like to build an Website. My team has years experience designing and developing mobile apps and Websites as well as SEO.I would approach your p More

$122 USD in 3 days
(102 Reviews)
5.9
joomsavvy

javascript! Hi there. I'm an Austin, Texas based developer with over a decade of php/mysql/javascript development experience. This sounds like a nice little side project. I'd love to chat a few minutes to get some s More

$155 USD in 3 days
(17 Reviews)
5.2
dbuglab

JavaScript Hi! I'm Mukesh, a 5+ years expeirenced web developer skilled at developing plugins and custom funtions for PHP frameworks and CMS systems like WordPress, Joomla, Drupal. <<<<<< I've seen your job po More

$120 USD in 3 days
(21 Reviews)
5.1
eighty3

JavaScript Hi there, Thank you for taking the time to consider our proposal, I am confident that our team can deliver fantastic results on time and within budget. We are Eighty3 Design Ltd, we’re UK based and have o More

$178 USD in 1 day
(25 Reviews)
5.3
freshdata

javascript Hello We have prepared a demo form. Please take a look. http://wp.freshdata.pl/ This is done in the form of a simple to install plugin WP (by Widget) After installing the plugin, you can go to Widgets More

$160 USD in 1 day
(15 Reviews)
4.5
AyanMukhopadhyay

javascript sorry I forgot to write this Please check this bellow link which I have done, I know what exact need to do.. http://testmyhosting.in/goodbox/ Waiting for your reply.

$88 USD in 1 day
(4 Reviews)
4.7
nexGENdevs

Hello, javascript, I am professional WordPress developer and can do this work for you. As per my understanding you need to insert some hidden fields upon filling of form. or before submission. I will do this and can More

$50 USD in 3 days
(26 Reviews)
4.2
lisa0002

javascript SALUTATION Hello Dear, My name is Rahul Keshwani. I have 6+ years of experience in:- HTML5, CSS3 WordPress, Woocommerce OPENCART, Magento PHP, MySQL AJAX, JavaScript, Jquery, BootStrap I am work More

$100 USD in 3 days
(8 Reviews)
3.8
BillyPons

javascript Hello Sir I have gone through your job description carefully and I am confident for your project. I am professional in Javascript and other languages. Hope to work with you. Thanks

$166 USD in 3 days
(1 Review)
3.3
pratikshapkl

Dear Hiring manager, I am a PHP developer My FIrst goal will always be to meet your needs and deadline. When working on a new project, I like to speak with the client, so that I can have a clear understanding of his More

$150 USD in 3 days
(19 Reviews)
4.1
admin852

***** javascript ******** Hello! I can complete the job fast. Looking forward to hearing from you. Thanks and regards!

$35 USD in 1 day
(7 Reviews)
3.4
khizarali47

Hi, Immediate Available, Expert of this task in JavaScript. Please visit few recent jobs performed: http://www.dkbdespatch.co.uk http://flyfame.com/ http://buzzoid.com/ http://panelupgradeexperts.com http://my More

$90 USD in 3 days
(11 Reviews)
3.1