I gang

HTML/PHP web form

This is a simple job for someone who knows HTML/PHP

I need an HTML form and PHP file that will send a text email containing the user's information in a specific format, redirecting the user to another webpage upon submission.

HTML Form must contain:

Product number (hidden, default value)

Product quantity (hidden, default value)

First Name (required)

Last Name (required)

Email (required)

Address 1 (required)

Address 2 (optional)

City (required)

State/Province (required)

Postal Code (required)

Country (required, drop-down: USA, Canada)

---------

Email format must be as follows:

To: (specified email)

Subject: New order was placed by John Smith

Body:

Order Information

(V4081305483) X 1

fname: John

lname: Smith

address1: 123 Fourth Street

address2:

city: Los Angeles

state: CA

zip: 12345

country: USA

b_fname:

b_lname:

b_address1:

b_address2:

b_city:

b_state:

b_zip:

b_country:

phone_day

phone_night

email: user email

fax

company

------------

Form should be straight HTML and PHP file straight PHP. I'll provide the email address, redirect URL, order number, and site info upon acceptance of the project.

Færdigheder: PHP, Web Design

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Om arbejdsgiveren:
( 35 bedømmelser ) chicago, United States

Projekt-ID: #288868