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Online Form

I am looking for someone to design/program a simple page on my website that allows someone to enter information for an online mortgage application. Some fields the customer will type data in, others will be a drop down menu. Some fields must be mandatory, others can be left blank. When they click proceed, all the info is summerized and they are given a chance to review it to send or make changes. If they click submit, all the info is then emailed to me and the customer automatically receives a confirmation email that the data was sent (email address being a mandatory field.)

There are about 60 input fields, with about 10 being mandatory.

Færdigheder: PHP

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Om arbejdsgiveren:
( 3 bedømmelser ) Toronto, Canada

Projekt-ID: #951277

Tildelt til:

EfficientDev

Will be glad to do it for $30 and a nice review -- if you'll be fully satisfied with the results, of course. More details in PM.

$30 USD på 1 dag
(29 bedømmelser)
5.6

10 freelancere byder i gennemsnit $44 for dette job

naumanrandhawa

Hi, Please check pmb for details.

$50 USD in 0 dage
(153 bedømmelser)
7.4
acesolution

lets do it ,........

$40 USD in 0 dage
(115 bedømmelser)
6.7
Samtiger2

Let's Begin.. Hope to achieve next positive feedback from you...please check your inbox

$60 USD in 0 dage
(66 bedømmelser)
6.6
borayeris

I think my skills are qualified for this project. PM me if you want me.

$70 USD på 1 dag
(25 bedømmelser)
4.9
russellcox

Hi. See PM. Russ

$40 USD på 1 dag
(22 bedømmelser)
4.8
mfawzylinux

Kindly Check your PMB

$35 USD in 0 dage
(16 bedømmelser)
4.7
vinphpmysql

Lets start

$30 USD in 0 dage
(32 bedømmelser)
4.3
SuperSoftware

Hello, We are a Brazilian team of programmers and we are interested in your project. We already made several sites for big and small companies using several techniques. We are ready to start immediately and really wa Mere

$50 USD in 3 dage
(2 bedømmelser)
2.8
rashadaliarshad

check your PMB.

$30 USD in 0 dage
(0 bedømmelser)
0.0