Hi there,
I can create a new working html page exactly similar to the funnel page your have refereed. It will have the form which will submit all user inputs to your email. But in order to add a working form functionality first I need to know where you are going to use this new page. So i can provide the best available option for the form. I can do it in both ways, custom form or any thirdpary form, whatever you preffer.
And you had forget to attach the code you already have.
Please feel free to discuss anything regarding this project before starting.
About Me:
My self Ajay KC, I'm a FULL-TIME Freelancer Designer Developer. I'm designing and developing Websites/Blogs for the past 7-8 years. I have good knowledge & and extensive experience in web design and development, including WordPress, Shopify, Google Blogger, Weebly, Custom HTML-PHP Websites, Bootstrap, CSS, HTML, javascript, and jquery. I can create or customize websites. I can write, edit or modify coding as per your requirements.
Looking forward to hearing from you.
Thanks