webpage with form that uploads a photo as well

Hello I am looking for a webpage to be built that is a simple form that also has a place to upload a photo as well.

The page would be for our maintenance staff at the church I attend

Most of the time this form will be filled out on a phone.

I would also like a link on the page that I can click on and log in to review the submitted forms.

I would also like to have a spot on the logged in page with the submitted form a spot to go in a add notes (who did the repair, what was done to fix the issue, cost of repair, etc.)

Also what would be great is to get an email with the form submission and the photo attached to the email (looking to send email to a few people)

Sample I put together....

[login to view URL]


Evner: HTML, Javascript, PHP, Web Design

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Om arbejdsgiveren:
( 5 bedømmelser ) Sun City West, United States

Projekt ID: #17815936

Tildelt til:


Thank you for posting a Job. I WILL DO THIS AS PER YOUR REQUIREMENT AND EXPECTATIONS. With the experience of over 300+web development projects including ANDROID, IOS, WEBSITES, WEB APPLICATIONS AND SOFTWARE Flere

$25 USD på 1 dag
(20 bedømmelser)

15 freelancere byder i gennemsnit $36 på dette job


Hello, I can build the form using WordPress and can also create an admin account so you can view all the form submissions. I have a 99% project completion rate and a 4.99 reputation (out of max 5.0 from more than Flere

$83 USD in 2 dage
(988 bedømmelser)

Hello, I am interested in your HTML project. I have 6+ years of experience in the web development section. See my another portfolio links too: [login to view URL] [login to view URL] Flere

$25 USD på 1 dag
(75 bedømmelser)

Dear sir! I am an experienced expert in building websites and landing pages for 6 years using html5, CSS and Javascript. Your specification seems to be written for me, not for others. I have done this kind of work s Flere

$25 USD in 0 dage
(38 bedømmelser)

Hi there, I've read the list of all requirements and can build a similar website for you having all features you mentioned including email with all detail. I've few questions: - Do you need any specific design? Flere

$94 USD på 1 dag
(44 bedømmelser)

Dear Sir. I can do it right now. I am interested in your job. I am a web developer from Russia who is specialized in Wordpress,PHP,MEAN,React and so on.I’m applying for your project spec offer for remote working Wo Flere

$25 USD på 1 dag
(7 bedømmelser)

Dear Recruiter, We are a CA-based in-house Graphic Design Agency for the past 7+ years now and have experience in developing graphics and brand identities from scratch. We have designed several Web/App designs, broch Flere

$30 USD på 1 dag
(10 bedømmelser)

Hi, I am a full-stack developer, I've BS degree in Computer Science, i have 6Y+ of experience in Web Development, Software Engineering, Quality, Linux. i am currently offering high quality work for very cheap price Flere

$25 USD på 1 dag
(5 bedømmelser)

Hello sir, I would love to take and complete your job. I will be working in PHP , mySQL and HTML/CSS. I have seen your given form design and i am sure i can get it done. I can start working right now , this is an e Flere

$25 USD på 1 dag
(2 bedømmelser)

Sir, i can provide quickly work, i got your project. I can start now. Message me so we can discuss more Thanks

$20 USD på 1 dag
(1 bedømmelse)
$15 USD på 1 dag
(0 bedømmelser)

I would like to be able to help you in this project, we will work on a responsive form so that it can be visualized without problems in a web browser or in a mobile phone.

$15 USD in 3 dage
(0 bedømmelser)
$88 USD in 3 dage
(0 bedømmelser)

I can create a form where you can upload images and it will provide all the functionalities you want, within a limited price, Please let me know if you are interested.

$20 USD på 1 dag
(0 bedømmelser)
$20 USD in 3 dage
(0 bedømmelser)