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I need the attached PDF turned into a PHP form that emails to the user. Basically, you are taking the contents of the form, and turning it into a page that the user can enter the info and it will email to an address that i designate to you.

The layout of the form fields should look similar to the PDF. I will send you the template file where you can insert the form fields. All fields are required so there should be validation. The validation should be easy to edit.

The email output should be formatted exactly like the form itself (
I don’t need the header and footer, but the agreement # and company property name should be on one line, then contact, phone #, and fax # should be on another line, etc etc)

Preference will be given to people who can get this done today.

TERMS AND CONDITIONS
Project needs to be complete within 24 hours of bid accept time.

Payment goes to escrow and is released when the project is done.

Place a realistic bid. I am a developer and know how long this should take. I don’t have the time to do it. If you do not place a realistic bid, then you will not even be considered.

No feedback? bad feedback? Do not bid

If you did not read the instructions, do not bid

if you do not clearly understand the requirements, do not bid.

I have an html webpage that i need an email form created on it. The person must beable to submit three photos through the form, that will then email me to an email address i will provide. I will also provide you with all of the text boxes to be in the form. form must be completed within 24 hours of project acceptance or a complete refund will be provided.

I want to create a review form like the one I’ve attached. The form needs to be created where I can send it out from my email, someone can fill out the form within their email when they “reply” and then send the form filled out with their information.

There will also be images within the email so I can upload the images to my server as needed.

Thanks,

JS

I need a very simple 2-page website. The first page will have a spot for a video on top, some text and an email form. The second page will be the “thank you page” after the email form is submitted.

Hello,

We need the email form on this page: http://bit.ly/mDOAkw to be working.

It will need to send the form to about 5 email addresses when someone submits the form. Also, we would like it to display a small message after the form has been submitted letting the user know the email was sent and they should receive a call back shortly.

Thank you!
Rory

I have a form at icustomworld.info and it is suppose to email me when submitted, the form is not working. I just need you to fix what ever the error is and make sure it give the “submitted successful message” need this done in less then 1 hour of acceptance of project if not a refund will be provided.

I require a programmer to take 5 minutes to look at my script and to update it so the information is sent properly and if any fields are left blank they shouldn’t be able to proceed.
You’ll be sent contact.html and contect.php.

I want to create a review form like the one I’ve attached. The form needs to be created where I can send it out from my email, someone can fill out the form within their email when they “reply” and then send the form filled out with their information.

There will also be images within the email so I can upload the images to my server as needed.

Thanks,

JS

I need an email form script. it should allow multiple form fields including attachments, that can be easily added/deleted (in code). It should send an email with the text fields + attachment(s). front end form can be simple but should include javascript for adding multiple attachments.

There will be about 115 fields that need to be filled out and the results need to be emailed to the admin.

I need the code tweaked on an email sign up form. i use mail chimp and want to implement the sign up form code with a template i already have.
this is a very simple and fast job and i’m available anytime.

I need a form when someone puts in the information. Submit it and it sent that information back to me through email and redirects them to a thank you page.

Its gonna be a quick 10 minutes job for you.

Eg: http://howtomakeapotatogun.com/question.html

I need a single webpage built from some of he information on this page

http://www.who2beton.com/handicapping-experts/the-prez/

The information I want is below the “The Prez Sports Handicapping Profile”

Please PM me for my details if you require it.

I need this built as soon as possible.

Simple Flash project:

I have designed a form in FLASH CS3 using the built-in components and I need to include the AS2 code and a PHP form handler to process it.

Features:
- error message for missing required fields
- go to next frame when for is successfully completed
- email auto-response to user
- email form input to me

I have this page: http://www.onestepfortune.com/Magnetic Sponsoring.htm

which is building a email list not in my control. I have a GetResponse auto-responder which I ALSO want to build AT THE SAME TIME.

Needs to be seamless, no extra forms, one entry to build two lists.

I need to services of someone who can develop a basic email form on a landing page of a pre-launch website. This landing page will allow a visitor to enter their email address and submit – the email address will be emailed to our admin team.
The graphic and interface has been designed. PSD’s and graphics will be provided. All I need is someone to script one form field over an existing image.
Once complete, i will provide access to my server to upload the script.
Thanks

I need someone to create the script for this email form on http://mklgenterprises.com/flu/index9a.

It needs to collect the information and then put it in a database and also send a copy of the information to a certain email address.

Hi Bhavi,

Further to our conversations earlier this week please find below a formal description of the project:

I would like for users to be able to search the “Agents” category and it’s subcategories, select a checkbox next to the each of the displayed Agents and have a pre-defined email sent to all the selected Agents’ by email.

Every email must be stored in the DB, with the following details:

Date Sent;
Agents Emailed;
Email Subject (pre-defined)

The above DB records/details should be available to the user.

Many thanks,

Claudine

I would like a script with the following features put together..

1. Users can be added via and admin area where the admin selects which industry categories they are subscribed to
2. Each user can access an account page to view balances and purchase credits via PayPal IPN (NO AUTHENTICATION NEEDED, USER CAN SIMPLY FOLLOW LINK IN EMAIL TO VIEW ACCOUNT PAGE)
3. When a visitor submits a quick quote using the form like www [dot] whichleads [dot] co [dot] uk an email is sent to the admin email address with details of the submission.
4. The admin then approves the submission and it is distributed to those users who are subscribed to the industry category.
5. A copy of the submission is also stored in a MySQL database.
6. If the user hasn’t any credits in their account they are sent an alert email with a link to the website where they can top up credits and proceed to PayPal for payment or chose an alternative payment method.
7. If the user has sufficient credits in their account they are sent the approved lead
8. The admin can manually add credits to the users account
9. A credit balance is sent with each email sent to the user

Should be pretty straight forward. Any questions please ask. This is urgent so looking for a coder who can jump on this asap.

I would like a script with the following features put together..

1. Users can be added via and admin area where the admin selects which industry categories they are subscribed to
2. Each user can access an account page to view balances and purchase credits via PayPal IPN
3. When a visitor submits a quick quote using the form like www.whichleads.co.uk an email is sent to the admin email address with details of the submission.
4. The admin then approves the submission and it is distributed to those users who are subscribed to the industry category.
5. A copy of the submission is also stored in a MySQL database.
6. If the user hasn’t any credits in their account they are sent an alert email with a link to the website where they can top up credits and proceed to PayPal for payment or chose an alternative payment method.
7. If the user has sufficient credits in their account they are sent the approved lead
8. The admin can manually add credits to the users account
9. A credit balance is sent with each email sent to the user

Should be pretty straight forward. Any questions please ask.

This is a re-posted project due to the last programmer letting me down so only bid if you are confident you can deliver and can get it to me ASAP.

I would like a script with the following features put together..

1. Users can be added via and admin area where the admin selects which industry categories they are subscribed to
2. Each user can access an account page to view balances and purchase credits via PayPal IPN
3. When a visitor submits a quick quote using the form like www.whichleads.co.uk an email is sent to the admin email address with details of the submission.
4. The admin then approves the submission and it is distributed to those users who are subscribed to the industry category.
5. A copy of the submission is also stored in a MySQL database.
6. If the user hasn’t any credits in their account they are sent an alert email with a link to the website where they can top up credits and proceed to PayPal for payment or chose an alternative payment method.
7. If the user has sufficient credits in their account they are sent the approved lead
8. The admin can manually add credits to the users account
9. A credit balance is sent with each email sent to the user

Should be pretty straight forward. Any questions please ask.

Hi, I need a form built in the next 2 hours. Here are the details:

- form will use my baisc design template
- I have a page that is already designed showing almost all of the form fields, so you will be able to copy & paste most of the code easily.
- will be locked and only accessible to logged in members
- will email the submitted data from the form to my email address
- will show the members name and email address

Thanks,
noah

Hi, I need a form built. Here are the details:

- form will use my baisc design template
- I have a page that is already designed showing almost all of the form fields, so you will be able to copy & paste most of the code easily.
- will be locked and only accessible to logged in members
- will email the submitted data from the form to my email address
- will show the members name and email address

Thanks,
noah

We have an email form on two pages that needs to be made functional. Right now we have the input boxes and submit buttons added but no code to make it work.

There are two pages that are very similar that need to be functional.

The form can be emailed by us to a client.
The client cant fill in the form in the email.
They can fill in the form in their browser.
They can Print it Out AND/OR Email it back to us using a buttons in the email.
On Screen Layout used as in SM1 Jpeg,
Fills in and Prints out A4 as SM1
Instructions appear at the bottom of email with Instructions button at top so it takes you to it when clicked.

When Instructions show from click the buttion “Back to Form” takes them back appears to return.

To view forms/project see links below

Form
https://www.scriptlance.com/f/?124497043954586317

Instructions for filling in form
https://www.scriptlance.com/f/?124497034610214690

Logos to be provided by us.

Quotations
1st Quote: For as above no payment
and
2nd Quote: For automated payment into Protx/Sage Pay

We need a simple php contact form, that when filled out and sent, it sends it in adf xml format (please see the attached document). Also, it would need to have some type of anti spam or spam injection, as well as go to a “Thank you.php” page. Very simple. I will provide the fields (Name, Address, Phone, Email, etc.).

1. Need someone to create an email form with 6 fields and display it with a lightbox effect when a ‘contact us’ button is clicked.
2. Email from form mail to be formatted and legible.
3. Link for ‘contact us’ will appear on 7 different pages in wordpress site.

HI

I need a php email form that based on what item they pick from a drop down box it will send an email to a certain address. Each item in the dropdown box has a different email address tied to it.

Each email address is tied to a autoresponder so the email address of the person who filled out the form will have to be seen by the autoresponder so it can response to that person

All the contact information must go into a database. It could be just a flat file (Excel format if possible)

After they complete the form that must go to a thank you page

It should be simple so I can just copy the code and put it on different html pages

I also need to add or remove items from the dropdownbox, do not need an admin section just need to be able to put a * in front so it does not show in the form.

Also all fields need to be filled, the form can not be submitted iif all fields are not completed.

Example

Name
Address
Email Address

Comment field

Dropdown boxes Email addresss tied to

North East north at email.ccom
South east South at email.com
west end West at email.com
Etc

Just need a form made to work properly to submit data to email address. Form and web page is already made out. Just need to have where the form requires certain fields and data can be sent via electronic email. Need someone who can do this very quick (couple of hours max). Must test code to work properly before escrowed payment is made. Will escrow payment directly upon choosing a programmer. Please see attachment for a view of the form. Required Fields need to be First Name, Last Name, Address, and Home Phone Number. Should pop-up a message if those are not filled out if the submit button is clicked without such required fields filled out.

All needs to done via web page code that will be provided (index.htm file) after you are selected. Site will be a leads type site.

I need CAPTCHA capability added to help prevent spam to an email form my site uses. The form is webformmailer.php on GoDaddy’s server. I would also like to be able to have you show me how I can add CAPTCHA myself in the future to other email forms on sites that will also use webformailer.php.

Simple Email Form
I need a simple email form installed and modified to match the font / layout of my existing website.

Work Required:
1) Create a simple email form:
a) Collect the following from user: Name, Company, Email Address
b) On User submission email user a predefined email with a specified PDF attachment

2) Modify form to match fonts and design used on website

3) On user submission, email attached PDF document to submitted email address

Website in PMB