Amend an existing website application form

We need a web-developer that will amend a website application form that I have. The link to this application form is [url removed, login to view]

Two changes needed please;

1) Under the question in the form that reads:

“Please confirm which finance or law firm you are currently employed at *”

Currently, there is a tick box next to each firm listed. The change I want is to have all the firms listed in two drop down menus.; one drop down menu for “Finance” and the other for “Law firms”. The user must select one (and only one) firm from EITHER of these two lists.

VERY IMPORTANT: When a firm is selected, the firm name and email address is automatically listed in the question below which reads:

Please confirm your work email address. This will only be used to verify your employment at (NAME OF FIRM SELECTED FROM PREVIOUS QUESTION). We will not send you any promotional material to this email *

In addition, right under this question is a blank text box, which must be populated, and right next to this text box is the email address of the firm that automatically appears when a firm is selected from the previous question.

These features must not be changed when you amend this form.

2) I want a secure admin area (with a username and password that I can change) that allows me to edit /add/remove firms that are on the list of finance and law firms. In addition I want to edit the email addresses of the firms that I add/edit in this list. E.g.

The admin area would allow me to edit/remove/add to the firms and email address rows.

Finance firms Email address

Bank of America @[url removed, login to view]

Barclays Capital @[url removed, login to view]

Citigroup @[url removed, login to view]

Law firms Email address

Allen & Overy @[url removed, login to view]

Ashurst @[url removed, login to view]

Clifford Chance @[url removed, login to view]

Please note: When someone completes this form I receive an automatic email with the answers. This feature in addition to all the other features of this form must not be changed. I only want the additions to this form shown above.

VERY IMPORTANT: To separate you from the spammers, please write LLAMAS as the first line of your bid. We will delete all bids that do not start with this word, since most bidders never read the requirements. Thank you for being one who does.

Please do not make bids high bids. Any bid over $80 will be ignored.

In addition to the job description above, I want another field in the application form. This is a field that is "Promotional code (optional)" this is an optional field blank text box.

In the secure admin area, I must have the ability to add a promotional code that when the user inputs into the text field in the application form, they will receive a discount that I can set from the admin area. Please note my payments are processed via paypal.

Also please add a new column in the excel sheets I receive when a user completes this application form that reads "Promotional code used" and shows me if a promotional code was used and what it was.

Evner: Grafisk Design, HTML, PHP, Web Design

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Om arbejdsgiveren:
( 11 bedømmelser ) United Kingdom

Projekt ID: #4066739

Tildelt til:


LLAMAS Please check your PBM, I have sent detailed information about your project.

$50 USD in 0 dage
(57 bedømmelser)

17 freelancere byder i gennemsnit $104 på dette job


LLAMAS We are a team of developers with expertise and experience in PHP and MySql. We have developed similar features - admin managing list that shows in front-end for selection. We have also integrated Paypal and c Flere

$150 USD in 2 dage
(848 bedømmelser)

LLAMAS Dear Sir, We would love to get this opportunity of working with you. We can guarantee that you will not regret your decision if you select us to execute this project. Regards NetzPro

$80 USD på 1 dag
(337 bedømmelser)

Please check my pmb

$75 USD på 1 dag
(392 bedømmelser)

LLAMAS! please check pmb...

$150 USD in 5 dage
(53 bedømmelser)

HI "LLAMAS", We gone through your requirement and explored the current form, we can code it as per your requirements, You can send PM for the Live Work portfolio.

$110 USD på 1 dag
(15 bedømmelser)

Hi LLAMAS Plz read the PMB for more details as we have gone through the entire details of the project requirement and ready to finish the same for you Thanks Shweta e-Marketing Pollux Technosoft

$80 USD in 2 dage
(15 bedømmelser)

PHP expert.. check pm pls!

$110 USD in 7 dage
(67 bedømmelser)

Hi, I can complete this project quickly and look forward to hearing from you. - Clarence

$80 USD på 1 dag
(4 bedømmelser)

LLAMAS Hi PHP expert here. Can start work right now. Regards

$250 USD in 4 dage
(19 bedømmelser)

LLAMAS Hi, This is a simple project and I can get it done in a day. Please let me know if you would be interested. Sent a PM with my portfolio. Thanks.

$120 USD på 1 dag
(3 bedømmelser)

I am a Graphics/Web Designer/Developer with 8+ years of Professional experience. I specialize in CMS designs (WordPress, Joomla, Drupal, ) Ecommerce (Magento , Zencart, Opencart) and responsive themes. I Specialize Flere

$150 USD in 10 dage
(3 bedømmelser)

"LLAMAS", Ready to work. kindly check pmb for details. thanks!

$75 USD in 2 dage
(6 bedømmelser)

Hi, We have expert developers and designers team, ready to start work for you, kindly check your PMB. Konnect Software

$150 USD in 5 dage
(1 bedømmelse)

LLAMAS Understood your requirement, will be glad to work for you and complete the project with full satisfaction.

$70 USD in 3 dage
(2 bedømmelser)

LLAMAS I am interested in completing this project for you. I will not take final payment until you are completely satisfied.

$80 USD in 4 dage
(0 bedømmelser)

Please check PMB

$50 USD in 5 dage
(0 bedømmelser)

LLAMAS Hi, I am freelance PHP developer from Malaysia. Please check your PMB.

$50 USD in 5 dage
(0 bedømmelser)