PHP/MySql - need quick form for website

Web, Mobile & Software Dev Web Development Posted 3 years ago


Hours to be determined
Less than 1 week

Start Date

January 30, 2013


Need someone to build a new web form (see attached).
- The form will need to be validated (required fields) in the browser, and at the server before user can successfully submit.
- When the form is submitted, it will insert into the database and send an email.
- The email sent will need to be made into a table (HTML email) for easy reading.

See attachment for desired layout.

Upon hire, we will provide web/FTP account and database connection info.

Open Attachment

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Activity on this Job

Last Viewed by Client: 3 years ago

Hired: 1

About the Client

(5.00) 4 reviews

United States
Charlotte 11:39 AM

10 Jobs Posted
70% Hire Rate, 1 Open Job

$1,976 Total Spent
7 Hires, 0 Active

$12.67/hr Avg Hourly Rate Paid
143 Hours

Member Since Jul 30, 2011