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Hosting Site - Simple Form

I have a hosting site at [url removed, login to view] which has got new servers and design.

I want someone to implement a form on the order hosting page that does the following:

1) Has fields for

Name:(text field)

Username: (text field)

Password: (text field)

Plan: (drop down box)

Paypal Email: (text field)

Contact Email: (text field)

And submits the above form information to my email and then continues to PayPal send payment.

Anyone who can implement a payment process to my site (secure) without PayPal would be preferred !

Please note this site has just started up so bid's will be chosen as lowest and best.

Thank you

Evner: C programmering, Perl, PHP, Web Sikkerhed, Web Design

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Om arbejdsgiveren:
( 38 bedømmelser ) Wakefield, United Kingdom

Projekt ID: #10262

11 freelancere byder i gennemsnit $50 på dette job


Please View PMB.

$20 USD på 1 dag
(144 bedømmelser)

Ready to start.

$50 USD på 1 dag
(26 bedømmelser)

I am the owner of a web hosting company so I know how this works. It'll be easy, contact me!

$30 USD på 1 dag
(3 bedømmelser)

We can do a standard form for you...no prob...using paypal and small admin panel for management....

$20 USD på 1 dag
(11 bedømmelser)

This is not too hard. I have stated 3 days but this is maximum. I have much experience and can sort you out with a professional looking enquiry page. Let me know if you still need help Thanks James Marchant

$50 USD in 3 dage
(1 bedømmelse)

See what I did on the DVD order page for www.braidsbybreslin.com. I can customize that to add your details....

$60 USD in 2 dage
(1 bedømmelse)

Please check Private Message Board. Thank you.

$20 USD på 1 dag
(0 bedømmelser)

we can do it.

$100 USD in 5 dage
(0 bedømmelser)

Hello, I am working as a sr manager with a product company having 13 yrs of exp. I am freelance developer too. Just completed a back-end implementation for PayPal for selling our products (downloadable in e-form) on Flere

$80 USD in 5 dage
(0 bedømmelser)

Hello will take only one to make it and only one hour to upload on your server , i have 80% work complete , so contact regards jack

$20 USD på 1 dag
(0 bedømmelser)

we have already done these kind of [login to view URL] check the link::[login to view URL]:: regards ::Sommet Gr Team::

$100 USD på 1 dag
(0 bedømmelser)