Secure Sign Up Form with Promo Codes

We need a secure, web based sign up form that can authorize and capture credit card payment information real time to be used with our gateway ([url removed, login to view]) This form will allow the person that is signing up to enter a PROMO CODE that will give them discount on the STANDARD prices. We must be able to create and assign the PROMO CODES.

Each PROMO CODE will range from giving the customer a 30 day FREE TRIAL or giving them a discount or giving them a completely FREE membership for life. See below examples.


$249.95 Set up Fee

$199.95 Annual Fee

$49.95 Monthly Fee


HH360-3030-031169 = 30 Day Free Trial

SG360-0111-031171 = Setup Fee waived (-$249.95)

GP360-0011-031172 = Annual Fee waived (-$199.95)

HS360-0001-031173 = Monthly Fee reduced (New monthly fee = $19.95)

This PROMO CODE code will work for a certain period of time, then change to another price or expire.

We need this up and running IMMEDIATELY. By IMMEDIATELY we mean hours not days. We are looking for a fast and functional solution. Hopefully using a system previously proven and working. We are not a technology company and are not familiar with the technical details (Ex:.what programming language to use, how the data is stored, etc...) We will rely on your suggestions, and recommendations. This is just Phase 1 of this project and we are looking to develop a relationship with whomever takes this job. Additional phases will include upgrading the form to a database of users, member's only access to web pages, etc...

Evner: Web Design

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Om arbejdsgiveren:
( 1 bedømmelse ) Miramar, United States

Projekt ID: #1000574

4 freelancere byder i gennemsnit $363 på dette job


please see [url removed, login to view] you

$400 USD in 20 dage
(37 bedømmelser)

Hi, Can be do it , please see your inbox . Thanks

$300 USD in 3 dage
(65 bedømmelser)

.net/php experienced

$500 USD in 5 dage
(6 bedømmelser)

Hello, I'm interested about design. I and my group can make cool designs for your Pay buttons for only $40-50. If you want to make example write PM. Best regards.

$250 USD på 1 dag
(0 bedømmelser)