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Email Form

I am looking for 2 PHP Forms with the following features:

- Ability to copy code into current layout.

- Email results to client and admin email.

- Thank You Confirmation

Form Fields Required:

Goalie Name (text field)

Date of Birth (text field)

Gender (checkbox) Male/Female

Email (text field)

Parent 1 Name (text field) Phone (text box)

Parent 2 Name (text field) Phone (text box)

Address (text field)

Apt/Unit (text field)

City (text box)

Province: Ontario

Country: Canada

Postal Code (text field)

Type of Training (dropdown) Private, Group

Number of Sessions (dropdown) 1 to 20

Level of Play (dropdown) AAA, AA, A, MD, House League

Name of Last Team (text field)

Heath Issues (checkbox) Yes, No

Explain (text box)

Payment Type: (checkbox) Email Money Transfer, Check/Money Order, Cash

Disclaimer: Once we have received your registration a staff member will email you with how to make your payment. Once we have received your payment your spot will be secured. All NSF Checks will be subject to a $25/charge.

Bid Requirements:

- All bids must contain in the post "I UNDERSTAND ALL YOUR REQUIREMENTS 100%", or your bid will not be even considered.

- Milestone payment of 50% requested only to start working. NO MILESTONES WILL BE RELEASE UNTIL PROJECT IS 100% COMPLETED and APPROVED.

Budget: $30

Taidot: PHP

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About the Employer:
( 15 reviews ) Stratford, Canada

Projektin tunnus: #4292958

16 freelanceria on tarjonnut keskimäärin 43 $ tähän työhön

wontonesaju

hi i have :) read your whole specification about form to email and also save it in the back end. i will commence this job immediately. regards saju

30 $ CAD 2 päivässä
(162 arvostelua)
6.6
Infenixwebs

I UNDERSTAND - Hi, I have experience in PHP email forms, the lowest I can do this is 140. Thanks

140 $ CAD 3 päivässä
(30 arvostelua)
5.9
csajit

I UNDERSTAND ALL YOUR REQUIREMENTS 100%

30 $ CAD 1 päivässä
(115 arvostelua)
5.4
phpplay

"I UNDERSTAND ALL YOUR REQUIREMENTS 100%",

30 $ CAD 1 päivässä
(17 arvostelua)
5.5
mushrraf

"I UNDERSTAND ALL YOUR REQUIREMENTS 100%" Please view P.M.B.

30 $ CAD 1 päivässä
(70 arvostelua)
5.4
noxtras

I UNDERSTAND ALL YOUR REQUIREMENTS 100%. I can do this tonight.

30 $ CAD 1 päivässä
(44 arvostelua)
5.1
lokjaiswal12

Hello, I UNDERSTAND ALL YOUR REQUIREMENTS 100% Please check PMB.

30 $ CAD 0 päivässä
(34 arvostelua)
4.5
html5css3php5

well understand your requirements..

30 $ CAD 1 päivässä
(11 arvostelua)
3.8
jovanovBogdan

I UNDERSTAND ALL YOUR REQUIREMENTS 100% Hi. I can do it fast and professionally

30 $ CAD 1 päivässä
(12 arvostelua)
3.6
mfumia

I UNDERSTAND ALL YOUR REQUIREMENTS 100% Greetings, I am interested in your PHP form project. I have coded numerous forms such as this and I am confident I can deliver the solution you require. I am available Lisää

30 $ CAD 2 päivässä
(21 arvostelua)
3.6
onlymaj

"I UNDERSTAND ALL YOUR REQUIREMENTS 100%" .i'm a web developer with more than 4 years experience .i'm ready to start !

50 $ CAD 0 päivässä
(4 arvostelua)
3.6
tonyshaeeb

I UNDERSTAND ALL YOUR REQUIREMENTS 100%

30 $ CAD 2 päivässä
(8 arvostelua)
3.1
XpertiaLogics

Hi, I UNDERSTAND ALL YOUR REQUIREMENTS 100% We have more than 6 years experience in web development. We have an expertise in asp.net, php, wordpress, mysql and many other technologies. We are very interested Lisää

30 $ CAD 1 päivässä
(1 arvostelu)
1.8
programwarrior

I UNDERSTAND ALL YOUR REQUIREMENTS 100% Dear Buyer, I this is a easy task and I can do this very efficiently as I have 7 years of experience . I am new on freelancer but I have enough experience to do this . R Lisää

30 $ CAD 2 päivässä
(1 arvostelu)
0.6
rkseries

I UNDERSTAND ALL YOUR REQUIREMENTS 100%,I have 7 years exp as website [url removed, login to view] get it done within 24 hours.

30 $ CAD 1 päivässä
(0 arvostelua)
0.0
lucky7jagriti

I UNDERSTAND ALL YOUR REQUIREMENTS 100% Hello sir, I have work experience in iPhone,iPad and android mobile apps development and game development.I have a good team of design,2D,3D animation work.I also have a good Lisää

230 $ CAD 10 päivässä
(0 arvostelua)
0.0
ShoaibRehan

Hello I have read your post and that have given me nice Understanding . So contact me for professional and efficient work. Thanks Hello I have read your post and that have given me nice Understanding . So contact Lisää

100 $ CAD 5 päivässä
(0 arvostelua)
0.0