I need info form for website

In Progress Posted 6 years ago Paid on delivery
In Progress Paid on delivery

Hello, I will need info form page with next details:

First Name __________________

Last Name __________________

Social Number _________________

Pin Code ___3 numbers__

Expire account (here I need month and year selector)

Zip Postal Code _______________

Country_________________

Email_________________

Complete action button, and after they hit complete button will recieve a message that their records was recorded.

I will need this infos to recieve on my mail on every signup to this.

Please add all this details in a nice div design, not more than 800px width and a big nice font, I will add after on my website.

Waiting for your bids!

CSS HTML PHP Website Design WordPress

Project ID: #15694680

About the project

68 proposals Remote project Active 6 years ago

Awarded to:

J0k3RBiH

This is for me a lakh job. I can work for you very quickly. I have an excuse in programming for more than 7 years. I hope we cooperate. Contact me on chat

$35 USD in 1 day
(117 Reviews)
6.7

68 freelancers are bidding on average $119 for this job

rinsadsl

Hi there I am interested in doing this project where we will design a nice form where you will enter the details and submit. It will get saved in the db and a confirmation will popup. Looking forward to working with More

$84 USD in 2 days
(1161 Reviews)
9.2
bestworkontime9

Hi, I have gone through with your requirements and I have exact match skills as the current project. I am an experienced web developer and ready to build a nice, clean and responsive design form for your website More

$103 USD in 3 days
(575 Reviews)
8.4
riteshjain009

//** READY TO START RIGHT AWAY AND PROVIDE YOU WITH IN NEXT 24 HOURS AS PER YOUR NEED **// Hello Sir / Mam, Greetings, Thank you for giving us opportunity to send our proposal on your project. I have gone throug More

$150 USD in 2 days
(502 Reviews)
8.5
inspirad

Hi, I am interested in this form configuration project. I checked your details and understand your requirements. I am ready to start. Possible to add a good design for this form. Thanks Shibu

$79 USD in 1 day
(862 Reviews)
8.6
raoasghar

Hey there! i see its just like form development when user's fill the form and you will receive all user's into into specific address . Let me know if we can start this job please Thanks

$250 USD in 2 days
(483 Reviews)
8.2
JamesTechnology

Hello there, i checked your requirement that you need info form page. I checked the all point as well. I am ready to discuss with you. please DM me. thanks

$222 USD in 10 days
(234 Reviews)
7.7
vuyiswankosi

Hello. I can complete the format you've described in 3+ hours. Is it just the form being emailed to you and then a confirmation for the user?

$35 USD in 1 day
(42 Reviews)
7.5
expertonphp

Hello Sir, My name is Mohit and I understand your project requirement carefully. I will create a nice form using bootstrap framework so it will be responsive too for small devices. Also, will validate before submit More

$30 USD in 1 day
(163 Reviews)
7.3
ravichedwal

Hello Sir, I have vast experience of web development & designing have developed many websites with client satisfaction have developed many websites & also have done form submission process. Once you chat with More

$155 USD in 3 days
(129 Reviews)
7.6
mondersky

I've seen the form structure and I am ready to buil you a fresh new modern and user friendly form with fields validation and storage to database + confirmation message and email sent to you. I think I am the right free More

$100 USD in 3 days
(231 Reviews)
7.2
Ripper1

Hello i can create you form like that with html,css+php for function i will need few hours to make it look good but i am sure you will be happy and it will be easy for you to integrate it regards

$50 USD in 2 days
(130 Reviews)
6.6
akgarg007

Hi, I can start immediately. I have read your requirement very carefully and I am pretty sure that I complete your task within given time and budget. Lets discuss on chat. Thanks

$111 USD in 3 days
(50 Reviews)
6.3
usmanredsoft

Good Day I'm Sr Word Press, Magento, Open cart, Joomla, Drupal, Html5, Java, Jqery Php & developer and I've 7 years experience working in word press website development. i will do this project according to your More

$222 USD in 3 days
(64 Reviews)
5.9
mizanrobi

Dear Sir thanks a lot to have look on my proposal. From your project description I have understand that, you are planing build an info form for your site and I am expert for this task. My relevant html , css , php , More

$100 USD in 1 day
(50 Reviews)
5.7
cometgroup

Hello, How are you? I have read your project description carefully I am very interested in this project. I have a lot of experience in this type of work. I'm sure I can complete it on time with high quality acco More

$100 USD in 3 days
(45 Reviews)
5.5
saaz109

Hello, I can develop info page with the given details. you will get a mail at every signup. looking forward to working with you Thanks Sapna

$66 USD in 0 days
(56 Reviews)
5.8
sabbibalam123

Hello I can build this form within 4hr. Can you please give me a chance to do a job for you? Looking forward to your answer. Regards Sabbib

$50 USD in 1 day
(30 Reviews)
5.2
logicpowered

We are very interested in this project. I have read your above description and i think its well within our range to execute this is in a good time frame so would you be kind enough to message me so we can have a fast a More

$70 USD in 2 days
(15 Reviews)
5.8
kellysharma

Hi there, This type of form we have created many times before for Hyundai and Barclays companies. Do you also need data to be downloaded in the form of excel file? However can we get connected over freelancer for More

$155 USD in 3 days
(11 Reviews)
4.8
MangoCoderz

info form for website CSS, HTML, PHP, Website Design, WordPress 7 years experience Please respond to me

$155 USD in 3 days
(8 Reviews)
4.4