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Create Website Form (ml)

I need to re-create the form on the front page of [url removed, login to view] using my account at http://jotform.com. It needs to fit neatly into the area currently used. (top right hanger)

I need to collect these fields:

First Name

Last Name

Title

Company

Phone

Email

Website

Referral (dropdown menu: referral, craigslist, yellow pages, search engine, other)

BUT HERE IS THE TRICK.... I NEED THIS FORM TO USE THE S2 HIGHRISE PROCESSOR...

[url removed, login to view]

Taidot: verkkosivujen suunnittelu

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Tietoa työnantajasta:
( 113 arvostelua ) Grand Rapids, United States

Projektin tunnus: #490384

4 freelanceria on tarjonnut keskimäärin 35 $ tähän työhön

indyaportal

Professional designer/developer here. Done many websites. Ready to start work. Please check PM for work samples and also check out my reviews.

50 $ USD 1 päivässä
(257 arvostelua)
7.3
efflux

Can give customize and 100% working form in an hr.

30 $ USD 0 päivässä
(122 arvostelua)
6.5
narinderbti

Please check PM.

30 $ USD 1 päivässä
(7 arvostelua)
5.3
sun1010

Please see my PM.

30 $ USD 0 päivässä
(16 arvostelua)
4.9