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Create online registration for an existing website

I am to move my product registration process from a physical registration card to online registration on an existing website. The website is already completed and I only require the addition of a page for registration.

The registration page should contain the following queries:

* First name

* M.I.

* Last name

* Mailing Address

* Home or Business

* City

* State

* Zip

* Home Phone

* Business Phone

* Fax

* Email Address

* Date of Purchase

* Model Number (located on "Made in USA" sticker)

* Name of Store

Attached is a copy of the physical registration card that we are currently using.

Færdigheder: PHP, Software Arkitektur

Se mere: online website registration, online card business, online business model, create online page, create business card online, online registration, online model, model physical, existing business card, create name card, name online store, php software registration, online registration software, copy fax number, create store name, move online, business email address usa, purchase registration online, create model existing, physical address website, addition existing, addition existing software, business card model, online sticker, usa fax

Om arbejdsgiveren:
( 16 bedømmelser ) Lafayette, United States

Projekt-ID: #6034208

4 freelancere byder i gennemsnit $126 for dette job

kchg

Hello, sir I'm interested with your project. I have good skill and my place is 8th in freelancer. I'll do it for you. I can do it well more than you could guess. :) If you give me t Mere

$226 USD in 5 dage
(168 bedømmelser)
8.3
mamoonraza

A proposal has not yet been provided

$66 USD in 0 dage
(34 bedømmelser)
5.0
merulaalba

A proposal has not yet been provided

$55 USD in 3 dage
(1 bedømmelse)
2.6
chintu007

A proposal has not yet been provided

$155 USD in 3 dage
(0 bedømmelser)
0.0