Simple php form for website with SMTP Authentication

I need a simple php form for my website with SMTP authentication.

The form needs to be put in the existing template of the website.

the form has four fields:

Voornaam (first name)

Achternaam, (second name)

Bedrijfsnaam (compagny name)

e-mail adres. (mail adres)

After the form is submitted its sends the contact details to a give mail adres and reguires smtp authentication.

The visitor gets a confrimation massage on the website and gets send back to the first page. and the given mail adres recieves the information.

I first like to see the lay-out of the form in an image. So i know how its going to look.

Im looking for someone who can do this task fast and not to expensive.

Thank you

Taidot: PHP, tietojärjestelmäarkkitehtuuri

Näytä lisää: smtp contact form php, website existing template, smtp mail form php, template php form, template simple contact form, php form contact, architecture website template, existing template php, task image php, authentication form php, smtp website, simple task php template, fast visitor, php form existing website, smtp software, simple send mail, template mail form, smtp php contact form, smtp php, simple lay website, php page authentication, php mail image, php mail form template, php image details form, php form simple

About the Employer:
( 7 reviews ) Bilthoven, Netherlands

Projektin tunnus: #4243860

Myönnetty käyttäjälle:


I am the expert here to help you with your project.PLease check my PM.

35 $ USD 2 päivässä
(10 arvostelua)

8 freelanceria on tarjonnut keskimäärin 89 $ tähän työhön


Hello, Please read the accompanying private message. take care, lee

60 $ USD 4 päivässä
(106 arvostelua)

We can develop this mailing script for you, ready to start.

180 $ USD 3 päivässä
(32 arvostelua)

Hi Have Gone through your requirement and understood, we are very sure that we can do your needs with your entire satisfaction. We have left a PMB for you plz feel free to have a look over there. Thnx Ram Webzin I Lisää

200 $ USD 5 päivässä
(48 arvostelua)

I am very much interested. Thanks

75 $ USD 2 päivässä
(17 arvostelua)

php expert is here.Having 8+yrs of experience.Ready to start Immediately.

100 $ USD 2 päivässä
(46 arvostelua)

Hi, I can do it perfectly. I have rich exepriences on this fields. Best regards.

150 $ USD 3 päivässä
(21 arvostelua)

Hello, I know exactly how to do this. More details on PMB. Regards, Andy.

35 $ USD 1 päivässä
(7 arvostelua)

Sir, I am very interested in your project.

30 $ USD 0 päivässä
(2 arvostelua)