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Need custom php contact form created for html website. Also need html edit to website.

Exact contact form mockup images created as reference. Please only PHP experts that can create custom php contact form and edit html code from scratch.

This should take less then a few hours to complete for PHP expert. Site is on PHP hosting (hostmonster) with php contact form application ready to use. Please see attached form mockup image attached.

Hi there,

1. I require a php scripted contact form for a personal website.

2. It should conform to the style of the attached .jpg file (i.e. text box borders 2-3px #000000 (black); font: Helvetica , also in #000000 (black) etc. Basically, the live form should look as close as possible to the attached image.

3. All fields to be mandatory. The dropdown menu for ‘subject’ will have four list items.

4. Input data to be emailed to a provided email address when user clicks ‘submit’ and co…

Ok, this is stupid simple.

I need a PHP contact form that sends an email to the email address in the hidden field.

The webform will send an email to the email that is in the hidden form like:
<input type=”hidden” value=”<? email >” />

The form fields will have:
- First Name
- Last Name
- Email
- Phone

After the user submits the form it will send the information collected to the email address in the hidden field.

I’m after a basic PHP contact form with the following fields:

- Name
- Email Address
- Message
- Attachments (user can attach a document which is sent with the email)
- Capatcha

Nice simple job for someone

Need a basic php email form to insert in a static website.
Fields Needed:
Name
Email
Phone
Subject
Message

I have a php form with ajax, but it is not submitting the form to the email address given, and I just want to change the formatting slightly as well.

I need a contact form where models can submit basic info like name, age, location, images and video files. The form will look similar to the form found here http://www.obsessedwithmyself.com/submit/

All the data will be stored on my server and will be retrieved by a download link which will be sent to my email address. I need to be able to copy and paste the forms HTML in any web site easily

I need a contact form where models can submit basic info like name, age, location, images and video files. The form will look similar to the form found here http://www.obsessedwithmyself.com/submit/

All the data will be stored on my server and will be retrieved by a download link which will be sent to my email address. I need to be able to copy and paste the forms HTML in any web site easily

Need php contact us script with captcha on website.
just 3 fields

name
email
comments

Hello,

I need a simple flash contact form to work on my domain (from godaddy.com). I will provide all login details to the domain. The form simply needs to send “name”, “phone”, “email” & “message” fields to the email I provide. I have the form designed, it just needs to send those fields on my domain, so you will need to upload the form and test it.

I need it done in flash CS3 or lower as I don’t have Flash CS4. Also it would be better if the form sent email using PHP can be used, although ASP is also an option.

Thanks.

I am searching for a PHP developer to build one “Contact Form”
similar to http://www.bookingentertainment.com/form.php
or http://www.jazzsalad.com/quick_quote_member/9654

I need a PHP programmer who can fix a contact form quickly. The form is working at http://www.harmonytakeoffs.com/contact.php. However, when the form is submitted without required fields filled in, it returns a blank form without any messaging. User should receive messaging that required fields are missing.

Need a very straight forward contact form.

HTML
You need to lay out the page like the attached jpeg.

Form needs to be html
Need to provide php send scripts with error checking
Need to provide instructions for adding drop down fields and editing message subject/ form information

JQUERY
need jquery function to display send success and send fail messages
Here is a great example: http://trevordavis.net/blog/tutorial/ajax-forms-with-jquery/

The page needs to degrade gracefully for browsers with no js enabled.

$10 for html form and php pages without jquery function
$20 for html form and php WITH jquery function

URGENT project, you need to deliver asap.

Please post bid with: “IAMNOTAROBOT” all bids without this will be ignored.

I have an XHTML/JS form at http://www.andrew-amanda.com/rsvp.php which currently doesn’t actually do anything, I just built the form.

I need someone to make it actually send the results to me (up to 3 email addresses that I specify in the config file) and function. It will also need to redirect to a thank you page when sent.

I currently have a working Flash AS2 PHP contact form that needs a little tweeking. The working form currently has dynamic text fields for NAME, EMAIL, SUBJECT, and MESSAGE. If a text field is left blank and a user tries to submit, they get a message asking them to fill in all fields (same with the email box). So far, so good.

This is what I need added/changed to the form. I need the categories to be named:

NAME:
COMPANY:
PHONE:
EMAIL:
WHERE DID YOU HEAR ABOUT US?

I also need a 3 question survey added via radio buttons. Each question will have 2 answers. I’m just collecting the data so it doesn’t have to give the user the correct answer, it just needs to submit the radio button data along with the other information. This should be easy for a programmer. Contact me for the files. THANKS!

Simple contact form (name, email, phone, date, comments and submit button) with JavaScript validation.

I need an existing form edited or created, in PHP to insert form data into a MySQL database (database is already created). I have screenshots, and examples in the attached MS word doc (Form.doc), and have included a pdf version (Form.pdf). There are examples in the zip archive which layout for you exactly what to do…

The form that my client likes is called Form to Mail. It is being used on 3 sites, however and has a big spam problem where people are spamming her and sending a lot of garbage to her. I am not sure if that is because of a flaw in the Form to Mail script.?? I would like that checked out. If that script can be edited and fixed easily, great. Otherwise, if it is not useable, you can use another form that does what is needed, as long as it functions as is needed, and visually looks like the one cited in my archive (zip file) here.

I need this done in the next 24 hours. There is no design needed – only functionality. Someone else will make it look pretty and fit into the existing site. I can be available to chat with you and assist in testing the form, etc.

Thanks so much!

I need one contact form adjusted on this website and another one added.

It needs to be done ASAP so if anyone can take care of it within the next 5 hours of this posting, please bid.

Attached is a .PPT explaining what is needed and this is where the website is: http://tinyurl.com/cfqh43

I need a contact form for my site that is php. The form should be protective against spam.

Hey I have a page (http://tinyurl.com/dmllzv) which has a “fake” form on the right (its exactly how I need, but isn’t a working form, and has “o”s instead of radio buttons, heh).

I just need the HTML “fake” form made into a real PHP contact form that will send to multiple emails (2 or 3 – if it can just be comma separated in the config file that’d be great).

Please only bid if you can start work right away, I need this in the next few hours. It is only 6 fields.