Need a simple web form created.

Hi Guys,

I need a contact form created for the site www.baysidemusic.com.au

It will need the following fields

Parent’s First Name

Parent’s Surname

Address

Suburb

State (ie Default “QLD”)

Postcode

Contact Telephone

Mobile (optional)

E-Mail (optional)

Where Did You
Hear About Us?











First Name of Child 1 Date of Birth

Child 1 is Interested in




First Name of Child 2 Date of Birth

Child 2 is Interested in




First Name of Child 3 Date of Birth

Child 3 is Interested in




First Name of Child 4 Date of Birth

Child 4 is Interested in


With some being drop down selections. The form will need to validate inputted fields before submitting (i.e the fields have text in them or a selection has been made).

Need it done in 24 hours from now so first come first serve . I will give someone $25 for it.

 

Also I forgot no design will be needed. It just needs to work on a simple html page and I will integrate a design later on.

Thanks

 

hope someone havent beaten me yet

 

Hey akdiver, is it already done?
I can do it for you!
Do you need a backend php script as well? or just the plain html form?
And also, can validation be done using javascript or you need server side like php?

 

just PM me i can do this

 

i can do this for you

50% advance

PM me if that suits you

Regards

Alex

 

The form has been done. Thankyou to you all for enquiring.

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