Contact Form with PHP Script

Cancelled Posted Jun 26, 2008 Paid on delivery
Cancelled Paid on delivery

We are looking to enhance the current contact form that can be viewed at: [login to view URL]

The form is HTML and the script should be PHP.

We want the contact form to have the following fields:

These ones are mandatory fields and there needs to be validation to ensure that they have been populated

Your full name

E-mail address

Your telephone

Company name

These fields are check boxes and are option fields but at least one of them must be selected. The default value is for them to be blank:

PerTOOLS Financial Analysis for Excel

PerTOOLS Data Extractor for Excel

The following field will be a list (we already have the values that need to be in the list and can provide them):

Country

When the user selects the submit button there should be validation to ensure the form has been correctly completed. we want an email to be sent to two different addresses.

The first email is to our email address and every time the form is submitted this address should receive a copy of the details.

The second email address will depend on which country the user has selected (e.g. if a user selects USA the details go to one email address, if they select the UK the email goes to another address).

For the look and feel of the form, please look at the current one at: [login to view URL]

Feel free to ask any questions. We are looking to get this done as soon as possible.

PHP

Project ID: #268829

About the project

38 proposals Remote project Active Jun 27, 2008

38 freelancers are bidding on average $36 for this job

phpplayer

Please check PMB.

$30 USD in 0 days
(19 Reviews)
6.2
infowayphoenix

I am ready to do the project with 100% satisfaction. please see pmb for details

$30 USD in 1 day
(13 Reviews)
4.8
srahmant

Please check your PM.I can do this project in timely. So i am sure i could complete this project successfully and you will be happy to work with me.I have 3 years professional experience on PHP,MySql,AJAX.

$30 USD in 0 days
(18 Reviews)
4.7
quintin671

I can get the form done in a quick and timely matter. PM if your interested.

$30 USD in 1 day
(10 Reviews)
4.3
beckerbao

This is a simple form. I can finish it in 4 hours

$30 USD in 1 day
(2 Reviews)
3.7
consc198

We can do this. Contact us for more information.

$30 USD in 1 day
(28 Reviews)
3.5
PHPMYSQLASin

Can I Fix it for you, thank you.

$30 USD in 0 days
(6 Reviews)
3.4
baseers

it can be done

$30 USD in 1 day
(15 Reviews)
3.4
wbtkolkata

Hi, I am a php developer and working with an IT company, I have handled various scripting application like this, so I am very much confident for this project. Thanks Wbt

$30 USD in 7 days
(4 Reviews)
3.1
funkyg

I can make a very usefull script that can allow You to: -Specify how many text fields do you want. -Specify which one is mandatory and which one is not. -Specify the names of the text fields. -Change/modify receivi More

$100 USD in 1 day
(4 Reviews)
2.9
businessmind

My Programmers are just ready for this start. It would be great boost for them if u can accept this bid. Very simple project. :)

$30 USD in 1 day
(2 Reviews)
2.9
DataDream

I have looked at the website and we can definitely offer you the functionality you require. We will make a point of contact available for updates, we are also based in the UK, so will be able to provide a turnaround in More

$40 USD in 1 day
(1 Review)
2.6
softpools

Hai, I am very much interested towards your work please look PM for more details

$30 USD in 3 days
(6 Reviews)
2.6
aymen86

I can start the work immediately.

$40 USD in 1 day
(0 Reviews)
0.0
coderofbd

We are very interested with your project. Please view PMB for more details. Thanks.

$35 USD in 2 days
(0 Reviews)
0.0
edysidea

i can finally your projrct at the current time.. thanks..

$50 USD in 10 days
(0 Reviews)
0.0
titu41

I would like to work with this project. I read the requirement of this project and i am sure that i could complete this project within very short time in successfully.

$30 USD in 0 days
(0 Reviews)
0.0
spider123

PM me for more details

$30 USD in 0 days
(0 Reviews)
0.0
abhishekchennai

i can do it

$30 USD in 3 days
(0 Reviews)
0.0
PhinWorks

It's already done, just post your payment and delivery is within 24 hours, database, email and contact form

$50 USD in 1 day
(0 Reviews)
2.8