Pop-up survey & secure customer application submit page

This project has two parts: 1. A pop-up screen that contains a brief survey and also sends the the customer a promotional email once they complete the survey. 2. A secure page for customers to enter sensitive financial data. This page should send this data to us via email. ============================================= 1. The pop up screen should appear as users leave our site. It should not be blocked by any anti-pop-up measures. It will contain a graphic showing a product that will be given away to a lucky person who has completed the survey. The survey will be contained on that page and will be carried out with a combination of user-modified fields (text areas), checkboxes, radio buttons and/or drop-down menus. The survey will fit on a single page and will be 10-20 questions in length. The email that is generated upon completion of survey should be easily modified by us. We also need survey results delivered to us via email. ============================================= The page/form for customers to enter financial data is pretty self-explanatory. ask me if you have any questions. ## Deliverables 1) Complete and fully-functional working program(s) in executable form as well as complete source code of all work done. 2) Deliverables must be in ready-to-run condition, as follows (depending on the nature of the deliverables): a) For web sites or other server-side deliverables intended to only ever exist in one place in the Buyer's environment--Deliverables must be installed by the Seller in ready-to-run condition in the Buyer's environment. b) For all others including desktop software or software the buyer intends to distribute: A software installation package that will install the software in ready-to-run condition on the platform(s) specified in this bid request. 3) All deliverables will be considered "work made for hire" under U.S. Copyright law. Buyer will receive exclusive and complete copyrights to all work purchased. (No GPL, GNU, 3rd party components, etc. unless all copyright ramifications are explained AND AGREED TO by the buyer on the site per the coder's Seller Legal Agreement). ## Platform all major webbrowsers.