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Make my form look web 2.0 appealing w/captcha

I need someone to recreate my form to make it very visually appealing, web 2.0ish...

I have attached a picture of what it currently looks like, then also a picture of something I tried with an online web form builder, but ultimately, did not work...

I have also attached a copy of the form page...

Please have a couple samples of your work that you can show to me...

The most important thing is that the form elements must keep their current names so that I can enter that data into the database table...

To add to this project...

Create a similar looking log in form, for username and password

Create a similar looking payment form with the following fields:
Full Name on Credit Card
Credit Card Number --> an image to the right of the input box with small credit icons of visa & mastercard
Credit Card Expiration Date
CVV/CVC Code --> a little pop up hint to show an image of where that is on the credit card
Address on file for Credit Card, which includes, address, city, state, zip code

These 3 forms should all look similar and very appealing and web 2.0ish

Compétences : AJAX, CSS, HTML5, Javascript, PHP

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Concernant l'employeur :
( 9 commentaires ) Pevely, United States

N° du projet : #1048745

Décerné à :

ecartsolutions

Jquery UI expert Can start on it right away and get it done in a few hours. Please check message board for details

50 $ USD en 0 jours
(269 Commentaires)
6.4

6 freelance ont fait une offre moyenne de 58 $ pour ce travail

brycep

Hi,Let's get it [url removed, login to view],Bryce

75 $ USD en 2 jours
(207 Commentaires)
7.8
SoftSandila

hi i can help, thanx, adnan

60 $ USD en 3 jours
(60 Commentaires)
6.4
cristisst

Please read Pm for more details.

80 $ USD en 1 jour
(107 Commentaires)
6.2
khu84

I have enough professional experience (4+ years) to do it right and deliver high quality work.

35 $ USD en 2 jours
(0 Commentaires)
0.0
CreativesolsUK

Looking forward to start the work Thanks

45 $ USD en 1 jour
(0 Commentaires)
0.5