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User Input Module

I have a website similar [url removed, login to view]

On the front page of the above website, there is a user input module requesting user name, medical insurance, phone number... etc.

I need the exact same module that emails the content to my email address and is also recorded in a database.

Compétences : PHP

en voir plus : Redesign a responsive home page of AIG\ S website at https://24hoursalesplatform.com , Redesign a responsive home page of AIG\ S website at https://24hoursalesplatform.com . Let your new design have a corporate and , i would like a flier designed with the broadcast services from my website anda list of all the uses (shown on website), cms, php, software testing, mysql, css, html, website design, software development, website testing, ecommerce, ajax, bootstrap, software architecture, javascript, graphic design, website managament, html5

Concernant l'employeur :
( 128 commentaires ) Bala cynwyd, United States

Nº du projet : #15165442

Décerné à:

gowtham15

A proposal has not yet been provided

%selectedBids___i_sum_sub_7% %project_currencyDetails_sign_sub_8% USD en 2 jours
(0 Commentaires)
0.0

29 freelance font une offre moyenne de $160 pour ce travail

hits

We have coded similar forms to save data, send as email for many sites. I am confident of delivering well. Pls share site url where this needs to be added,validations needed, values for dropdown lists Relevant Skills Plus

%bids___i_sum_sub_35% %project_currencyDetails_sign_sub_36% USD en 2 jours
(929 Commentaires)
8.9
extreamcode

HI Sir/Madam, I can assist you with "User Input Module", I have experience working with "similar Development". Let's have a quick chat to discuss it further. Relevant Skills and Experience I have been in this "Develo Plus

%bids___i_sum_sub_35% %project_currencyDetails_sign_sub_36% USD en 3 jours
(60 Commentaires)
7.4
NickolaS

HI, I can make this form for user details within a day Соответствующие навыки и опыт 12 years PHP Предлагаемые промежуточные платежи $100 USD - full escrow

%bids___i_sum_sub_32% %project_currencyDetails_sign_sub_33% USD en 1 jour
(340 Commentaires)
7.5
webXpart

Hi, I checked your project details and checked the example site. I understand your requirement and i confident on it. Please come online and give me your site link so i can check and start working. Please check m Plus

%bids___i_sum_sub_35% %project_currencyDetails_sign_sub_36% USD en 3 jours
(49 Commentaires)
6.6
%bids___i_sum_sub_35% %project_currencyDetails_sign_sub_36% USD en 10 jours
(77 Commentaires)
6.3
BizzCreator

Hi, We are a team of professional web designer/developer, we are experts in Wordpress, Joomla, Ecommerce, Shopify, PHP, MySql, Responsive, Bootstrap, HTML 5 / CSS3, Landing page, PSD to HTML and etc. Relevant Skills Plus

%bids___i_sum_sub_35% %project_currencyDetails_sign_sub_36% USD en 3 jours
(45 Commentaires)
6.0
anamaria1979

have a website similar [login to view URL] On the front page of the above website, there is a user input module requesting user name, medical insurance, phone number... etc. I need the exact same module Plus

%bids___i_sum_sub_35% %project_currencyDetails_sign_sub_36% USD en 0 jours
(142 Commentaires)
6.5
infowider11

Hello,I m a Web and App Developer cum designer with 7 years' of exp.I just go through your requirement, i m showing interest in your project bcoz i m doing same type of job , i can show you demo Relevant Skills and E Plus

%bids___i_sum_sub_35% %project_currencyDetails_sign_sub_36% USD en 15 jours
(42 Commentaires)
6.0
shafayat671

Hi, I can make your emai content. It will take 3 days and my budget is $155. Pls ping me for more discussion. Thanks, Shafayat. Portfolio: [login to view URL] Relevant Skills and Experience Language: PHP, HTML, CSS, My Plus

%bids___i_sum_sub_35% %project_currencyDetails_sign_sub_36% USD en 3 jours
(47 Commentaires)
5.7
XpertSolNet

Hi, I have already developed many websites and very much proficient in starting this project with you according to all your specifications. Wasi Relevant Skills and Experience [login to view URL] http://fridaypos. Plus

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(21 Commentaires)
5.5
vismat

I have read your job description very carefully and understood that you require an web developer. Relevant Skills and Experience I have more than 6+years’ experience in Web Design & development Like WordPress, Woocomm Plus

%bids___i_sum_sub_35% %project_currencyDetails_sign_sub_36% USD en 3 jours
(16 Commentaires)
5.4
ruwanjayawardena

Hi..Have a Good Day, Pls Contact me via freelancer chat.I need to discuss more about your project requirement in detail. I'm standalone custom php developer. Thank you. Relevant Skills and Experience # Proposed Miles Plus

%bids___i_sum_sub_35% %project_currencyDetails_sign_sub_36% USD en 3 jours
(25 Commentaires)
5.7
brianconey

HI there? As a highly skilled PHP Web Developer, I read your posting for a new PHP Web Developer with interest. So I am sure I can accomplish your project. With more than 8 years’ experience as a PHP Web Developer, Plus

%bids___i_sum_sub_35% %project_currencyDetails_sign_sub_36% USD en 3 jours
(39 Commentaires)
5.6
wsafreelancer

HI! I m interested to make follow website user inpput modules etc as you mention in project descriptions once contact me i will start work immedialtey and complete it as your requirement Relevant Skills and Experienc Plus

%bids___i_sum_sub_35% %project_currencyDetails_sign_sub_36% USD en 3 jours
(71 Commentaires)
5.4
saritamahar

Hello, I reviewed your reference site and I assure that I can create an exactly same module on your website. I can complete that work within 2 days. Please enable the chat for further details. Relevant Skills and Expe Plus

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(31 Commentaires)
4.7
chnabeel002

Dear Sir, We have evaluated the project in detail and we came up with a proposal that is appropriate for your needs. With our aim to help you achieve your project’s goal. Thanks. Relevant Skills and Experience PHP, Plus

%bids___i_sum_sub_35% %project_currencyDetails_sign_sub_36% USD en 3 jours
(17 Commentaires)
4.4
rockstardev3

Hi. I have reviewed your project and can do your job within 3 days. I will show good skills. Relevant Skills and Experience php Proposed Milestones $155 USD - one time.

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(14 Commentaires)
4.2
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(12 Commentaires)
4.2
Rekhathakur

I gone through website [login to view URL] I completely understood your requirement I have already designed and developed many Website with required functionality and features can start now. Relevant Skills a Plus

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(4 Commentaires)
4.1
JinYongbin

I have a lot of experience in development of project like what you want. If you hire me, I will do my best to develop your project wonderfully in a short time! Relevant Skills and Experience I have more than 5 years Plus

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(3 Commentaires)
3.8