A Support contact form

Cancelled Posted Feb 12, 2013 Paid on delivery

$30-250 USD

Paid on delivery

Cancelled Paid on delivery

I need a ric text contact form with a capch and an upload feature created please the upload will be an attachment to the email sent.

I would like nice css turquoise gradient style for the fields.. on white background please..

I want the form to send me their ip address, their os, their host, their browser and country please.

It needs to have a thank you on submit function, just a simple thank you page.. I will adjust the template.

PHP

Project ID: #4238695

About the project

5 proposals Remote project Active Feb 13, 2013

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5 freelancers are bidding on average $68 for this job

wwwlayer's Profile Picture
wwwlayer

Ready to work on your project.

$60 USD in 0 days
(144 Reviews)
6.1
vickymudgal's Profile Picture
vickymudgal

Hello Please check PMB Thanks

$150 USD in 3 days
(20 Reviews)
5.6
RazHarush's Profile Picture
RazHarush

Within 1 day - Captacha, upload feature, the requested pages and free technical support! Award my bid now and we'll get working!

$50 USD in 1 day
(7 Reviews)
4.2
teamvalid's Profile Picture
teamvalid

Hi! I can develope this form for you with requirements. Accept my proposal and provide details about where it needs to be integrated. Thank you. ~Shakir Shabbir

$50 USD in 2 days
(1 Review)
3.8
bryandev's Profile Picture
bryandev

Ready to start right now! USA Based developer - Can finish in 1-2 hours

$30 USD in 1 day
(3 Reviews)
1.8
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