Advanced Contact/submit info form Needed...

Discussion in 'HTML & Website Design' started by cougarxs, Jun 21, 2008.

  1. #1
    G'day guys..

    Ok i am looking for someone to design a simple contact form for me.. I need it to send me an email of the users responses, at the same time i need it to redirect to my paypal subscription page..

    im happy to help you work on it also if needed i am just having trouble, making it send me an email & redirect to my paypal subscription page.

    MUST BE PROFESSIONAL DESIGN..

    Inputs as follows:

    personal info: <<user input>>
    - First name: [ ]
    - Last name:
    - Email address:

    Business info:
    - owners name:
    - business name:
    - business number:
    - telephone number:
    - Business email:
    - Business mobile number:
    - Business fax number:
    - city:
    - state:
    - post code:
    - Trading Hours
    - Select a category:[drop down box here]
    Business description:
    [ text box here ] 200 words max

    Keywords:
    [ text box here ] 25 words max

    Services:
    [ text box here ] 50 words max

    Select a supscription: [dropdown menu] (4 choices, each one points to a different paypal subscription)

    Terms and conditions:
    blah blah blah blah blah blah blah blah blah blah
    blah blah blah blah blah blah blah blah blah blah
    blah blah blah blah blah blah blah blah blah blah

    I Agree [ check box goes here ]

    [Submit]

    As you can see not alot of work at all, i need ASAP ... ive got pretty much every thing done my self but as i said at the top im having trouble making it redirect & email me the users data..


    reply if you can help me out, im far from rich at the moment, but i'll make a small contribution to your paypal account, or even just post a quote ...

    i just ask that it looks professional & works as mentioned above..

    ok im waiting on your replies Thanks
     
    cougarxs, Jun 21, 2008 IP
  2. priyakochin

    priyakochin Banned

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    #2
    If ur interested to hire someone PM me.
     
    priyakochin, Jun 22, 2008 IP
  3. cougarxs

    cougarxs Peon

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    #3
    still looking for some help on this ...

    $10 - easy money to complete a form for me with the "OP" categories
     
    cougarxs, Jun 22, 2008 IP