Help clean up my website

I need one page (and some file structure) cleaned up on my website. It's basically one form that needs to be reformatted; I also need the winning bidder to figure out where the information from the form is being saved. Here's the punch list:

1) The “Representative Number” should be replaced with “Representative Name” and should be pulling from the login

2) If you don’t answer the questions, you lose data from some of the fields – you should keep data from the fields complete

3) The “Call Date” seems to reset to 12/31/1969 rather than whatever it was that the user entered

4) After the user enters data and clicks “submit,” the form should be wiped clean.

5) The format is ugly – please make it all appear on one screen, align text more carefully, etc.

a. Rep number, Call Date are out of line

b. “Call Result” is a header for the five radio buttons that all start with “customer”

c. “Customer only sort of interested” runs into the line below

d. “Name of Business” is out of line with rest of items in that box

6) For some reason I’m getting a \ in front of an apostrophe in front of the text box called “Name of Business”

7) It’s OK to have null values in “What sales approach...” “Do you have any questions” and “Could we improve...”

8) I can’t find the form information on my website.

Full details and a login will be provided to the winning bidder.

Taidot: verkkosivujen suunnittelu

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Tietoa työnantajasta:
( 31 arvostelua ) Columbia, United States

Projektin tunnus: #487491

Myönnetty käyttäjälle:


Ready to do this..thanks

$100 USD 1 päivässä
(15 Arvostelua)

6 freelanceria on tarjonnut keskimäärin %project_bid_stats_avg_sub_26% %project_currencyDetails_sign_sub_27% tähän työhön


have a glance at PM. Regards,

$116 USD 1 päivässä
(53 arvostelua)

Hello,I am ready to start now,please check your PMB,thanks

$89 USD 0 päivässä
(61 arvostelua)

Please see pm

$140 USD 1 päivässä
(7 arvostelua)

Detail will be sent to PMB.

$150 USD 3 päivässä
(5 arvostelua)

Hi,I can provide,check pm.

$120 USD 1 päivässä
(6 arvostelua)