Website Form - repost

Avg Bid (USD)
Project Budget (USD)
$10 - $30

Project Description:
I need a form that will allow users to select a category, years of coverage, then the submit button will take the user to a page to purchase the plan based on the category. There will be approximately 8 combinations. I will provide a PSD layout of how the form is suppose to look. The copy will be dummy copy due to the confidential nature of the project. In turn, I will need a commented HTML file as well as supporting css and javascript, so I can update with the appropriate copy and links.

Skills required:
CSS, HTML, Javascript
Hire ahmedfathig
Project posted by:
ahmedfathig Egypt
Public Clarification Board
Bids are hidden by the project creator. Log in as the employer to view bids or to bid on this project.
You will not be able to bid on this project if you are not qualified in one of the job categories. To see your qualifications click here.

$ 360
in 9 days
$ 205
in 7 days
$ 50
in 3 days
Hire phongpp2000
$ 30
in 2 days
$ 35
in 1 days
$ 30
in 1 days
Hire kZLOYhjzNkkQ
$ 25
in 1 days
Hire zaluma9
$ 88
in 6 days
$ 25
in 2 days