Web Form Needed

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Bids
82
Avg Bid (USD)
$83
Project Budget (USD)
$25 - $125

Project Description:
I need webform built and integrated into my existing website.

1. On the existing page we need a button that states [Report Problem]
2. When the button the user will be taken to a page or pop-up and fill out the following information:
- a. Name (single line)
- b. Email Address (single line)
- c. Phone Number (singled line/ xxx-xxx-xxxx format)
- d. Problem Reported (multi-line)
3. When the user clicks submit the following should happen:
- a. an email with the information provided needs to be sent to (3) pre-defined email addresses
- b. the user should receive an email as well indicating that the problem report has been received
- c. the user should be returned to the original page where they clicked on the button to report the issue

4. Regarding item #2 above. The user should only see the form when the support department is closed. When the support department is open, the user should recieve a message indicating that the support desk is open and to call a specific phone number. Users SHOULD NOT be able to see the form to submit issues per the schedule below (all times are Pacific or GMT-08:00).
- Monday - Friday 4a - 6p
- Saturday 5a - 1p

All of this code needs to be compatible with ASP & /NET. This will be running on MS IIS server. Also the SMTP server will be the local host as well (127.0.0.1). This needs to be done within (2) days.

Skills required:
.NET, ASP, HTML, Javascript, Website Design
Hire FluidNetsDamianS
Project posted by:
FluidNetsDamianS United States
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