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Need a simple PHP web form created

I will have a page in HTML like shown on my blog --but need a PHP developer to code back-end functionality for this form. What will you charge so that a customer can fill out the rectangles in the form as shown --and be sent to a landing page to thank them-- plus email me the answers along with the questions? Thanks

Skills: PHP, HTML, Website Design, JavaScript, MySQL

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About the Employer:
( 77 reviews ) Austin, United States

Project ID: #25616894

58 freelancers are bidding on average $31 for this job

hits

What I understand is that the form design is implemented on your site in HTML and I enable entries in form (all will be text fields? any validations needed) and on submission show a thank you page (this already exists) More

$100 USD in 2 days
(1004 Reviews)
9.1
nddungha

Hello, My price to make this "Start a Project" HTML form become functional is 45 USD and 2 working days. Could you send me the files? Thanks and regards, Ha Nguyen

$45 USD in 2 days
(343 Reviews)
8.0
malviyamanish

Hello sir, I have gone through your job description. I am full stack developer . I have 6 year of experience in web designing and development. I've sound knowledge PHP, CI, Laravel,React, Node.js, Angular, WordPress More

$30 USD in 1 day
(297 Reviews)
7.9
webxtreams

Dear sir I have experience with PHP website developments and customization, i can write code to validate form, submit,send mail to you and redirect to the above page, ready to start work from now. Regards Suneth

$25 USD in 1 day
(566 Reviews)
7.1
khyatiraval

Hello, I understood project description and i also checked attached image. I have couple of question to start work. Please open freelancer chat and let's start.

$30 USD in 1 day
(299 Reviews)
7.3
ARKSolution2015

Sir, I have gone through your project description and am looking to provide my service for a simple PHP web form created. Please leave a message on my chat so we can discuss the budget and deadline of the project. For More

$150 USD in 10 days
(200 Reviews)
6.8
pabloramirezdz

Hi there! My name is Pablo, I'm a developer and sysadmin with 12+ years experience. I have excellent knowledge of php, and I can make the changes to send your form through email, we will need to make the form to point More

$45 USD in 1 day
(60 Reviews)
6.5
dynamiccreator

HI, I am a professional developer and got your requirements of PHP form perfectly Yes I can make this form in php, all the data will be emailed you in format with thank you page redirection to the user. Looking for po More

$30 USD in 1 day
(133 Reviews)
6.2
tiwariraushan71

Hi There, can create form for you. I am PHP experts having combined experience of more Than 6 years in PHP Framework :- Drupal,Prestashop,Shopify, Wordpress, & BIgcommerce and already completed more than 500 projects More

$20 USD in 1 day
(162 Reviews)
6.3
amit0423

Hello there I am a web developer with 7 years of experience in PHP. Please get back to me to discuss more about your project. Regards.

$100 USD in 7 days
(35 Reviews)
5.8
vetdobr2

Hello How are you? I am very interested in your project. I have done such kind of project previously. So, this is a piece of cake for me. I am 100% sure to fulfill all the requirements in time. Please discuss in detail More

$120 USD in 1 day
(9 Reviews)
5.0
lxitservices1

“I CAN DO” Hi there, Greetings!! We have read your project requirements and we have understood that you want to code back-end functionality for this form I have extensive experience in photoshop,illustrator,psd to ht More

$50 USD in 2 days
(34 Reviews)
5.6
eliaa

Hello, I have gone through your requirements and understand what you need. I am a Web developer with 7 years experience I have used a lot of technology to implement my clients solutions. List of Services that i can hel More

$30 USD in 1 day
(21 Reviews)
4.8
TeamDPS

hi sir will complete it in a couple of hours in a low charge. myself 6 years experienced web developer and my aim to provide satisfied work. you can check my reviews for assurance of quality work. ping me for more disc More

$20 USD in 1 day
(53 Reviews)
4.8
vipinjain1213

Hello, I can help you out.I believe I will be suitable for this job and serving you with all my hard work and skills.I am available on the chat so let us discuss there.I am a website designer/Developer. I am well verse More

$20 USD in 7 days
(22 Reviews)
5.1
psharma3368

Hello sir, I can create php code to submit this form and after submit form redirect user to thank you page and send these all form detail on your id. please text me so we can start work. thanks

$30 USD in 1 day
(21 Reviews)
4.5
salientdevloper

Hello I am a full service provider for corporate or individual interested in designing their design & development needs of web based projects. We are experts in HTML,CSS,Boostrap,Jquery,Javascript,core Php, Magento, More

$30 USD in 1 day
(4 Reviews)
4.2
CloudAdvisory

Hi,I specialize in website design and development and am excited for this opportunity to work with you in accomplishing your goals. I am a full-stack developer with 8 years of experience. I have worked on several proj More

$20 USD in 7 days
(5 Reviews)
4.3
nancydeveloper

Hi, ----- Need a php developer who can work functionality of html form *** HAVING 6 YEAR EXPERIENCE IN PHP *** As per the job description, I understand that you are looking for an expert PHP developer for your respe More

$30 USD in 2 days
(31 Reviews)
4.5
rehmatsayany

Hi there, I work dedicated for one client at a time. 24/7 available. I am technology specialist with several years experience in the fields of Data Science, Web Development. I work on low cost and deliver on time. M More

$25 USD in 7 days
(35 Reviews)
4.6