Hi, I want to hire a php developer to create web form with following fields: The information I need in the form is Moving Details: Estimate Moving Date*: 00/00/0000 Moving From: State: State-List City: XXXXXXX-Write Zip Code*: 00000 Moving To: State*: State-List City: XXXXXXXXXXX-Write Zip Code: 00000 Personal Information: First Name*: XXXXXXXXXX-Write Last Name: XXXXXXXXX-Write Phone Number*: 000-000-0000 Ext: 0000 Phone Number 2: 000-000-0000 Ext: 0000 Email*: How did you hear about us*: List; Google, Yahoo, Search Engine, ,,,,,,,,l? Click Here To Submit your inventory items: {in this area I need to have inventory list items that customer can submit, I need inventory list like the one in the bellows domains list} Comments: Please enter your comment over here or add items you could not find in the list Get Quote For example: kingdavidmovers.com/index.php?option=com_estimate&view=estimate&Itemid=678 We need full code of above form so that i can put it in my websites. so please Send me PM with cost and time.