Create a Wordpress Template Form

Cancelled Posted Feb 26, 2015 Paid on delivery
Cancelled Paid on delivery

I need a wordpress form that allows data input and is emailed to administration.

Here are the elements of the form:

org name

company address (use the google map showing lat/long)

pointofcontact

details

url

time

email

phone

fax

upload logo

services(multiple selections can be chosen from excel file attached)

are you a veteran owned business (yes/no)

add credit card info to the form. card no./billing address/city,state,zip/exp date/sec code/ also add place for electronic signature

Also add in a dropdown these choices of programs: Promote Publications Monthly - $9.99/Promote Publications Annual - $99.99/Create Events Monthly - $14.99/Create Events Annual - $49.99/Advocate Profile (non-profit/small biz) Monthly - $19.99/Advocate Profile (non-profit/small biz) Annual - $199.99/Advocate Profile (govt/corporations) Monthly - $49.99/Advocate Profile (govt/corporations) Annual - $499

CSS HTML PHP WordPress

Project ID: #7209321

About the project

35 proposals Remote project Active Feb 26, 2015

35 freelancers are bidding on average $418 for this job

fastworkontime1

A proposal has not yet been provided

$378 USD in 10 days
(971 Reviews)
8.8
sandyIN

A proposal has not yet been provided

$515 USD in 10 days
(538 Reviews)
8.9
gyaseen1986

A proposal has not yet been provided

$315 USD in 10 days
(1096 Reviews)
8.8
rabbul

Hi I am confident to do this job. ========================================================================= thanks

$277 USD in 3 days
(579 Reviews)
8.3
malviyamanish

A proposal has not yet been provided

$400 USD in 10 days
(306 Reviews)
8.1
TheExertion

Hello Good Day, We have read your project and absolutely confident to say that we are the right team for this job. We will make the form with all the fields as you required. As there are payment options and credi More

$263 USD in 3 days
(222 Reviews)
7.7
majma01

A proposal has not yet been provided

$263 USD in 1 day
(268 Reviews)
7.3
narendra1

I will build the form with all mentioned fields. I will start work right now. I will provide you quality work in timely manner.

$526 USD in 8 days
(132 Reviews)
6.8
sunil8986

Hi There, Kindly consider our bid for your project. We will not let you down.. WordPress is our Expertise Area.. :) Thanks, 2Swebsolutions

$526 USD in 12 days
(222 Reviews)
6.9
suntechnology47

hi I understand the form that you want, I have also done similar thing to another client and I totally understand your project

$250 USD in 3 days
(55 Reviews)
6.3
sisodiakaran

Dear Employer, Let me introduce myself as an expert software programmer and am really interested in working with you. I have done many offline jobs. I am willing to complete your job at a very fast pace and at a min More

$275 USD in 5 days
(20 Reviews)
5.3
yaroinfo

A proposal has not yet been provided

$333 USD in 3 days
(32 Reviews)
5.4
Geniusteam

A proposal has not yet been provided

$1134 USD in 20 days
(3 Reviews)
4.6
wavetechline24

Dear Sir, I have analysed your requirements and can work on it. I can guarantee quality work on time with testing and support.I can provide you with attractive designs as per your requirements. Please PM for fur More

$350 USD in 4 days
(19 Reviews)
4.2
webmagicwizards

Hi, We have studied your requirement and we will provide you wordpress plugin which create a wordpress template form through shortcode . After submitting the form a email will be sent to administration and also admi More

$250 USD in 10 days
(11 Reviews)
3.8
CybernateS

Hello, We have over 6 years experience in WORDPRESS Development on both Linux and Windows platforms. We having our own designers for handling any type of designs and html5 work. Our team having experts who are Mic More

$611 USD in 20 days
(9 Reviews)
3.4
CoreCoders

I am ready to get started with this task right away and I can assure you a guaranteed solutions. Let’s discuss in PM for more details. Thanks!

$473 USD in 4 days
(8 Reviews)
3.1
markobest

Hi, Ready to help you right now. We specialize in Wordpress and php, please refer to pmb for more details. Thanks

$300 USD in 10 days
(15 Reviews)
3.0