java/jquery submission form

Avg Bid (USD)
Project Budget (USD)
$30 - $250

Project Description:
I am looking for a copy of the 2 step heat bleed contact app on the following site: If you enter the following UK postcode: m3 6fp (on the right of the page where it asks for a postcode) you can see how it works and takes you to the second page where you can alter the jquery dynamic options to adjust the price and ultimately it has a send script attached (which I would want to send to an email address) to pass the data back. Styling of the first page does not have to be fantastic it can be really basic it is more the second page with and the dynamic elements and the css involved. I am on a budget so please bid competitively, if you look at my stats you will see I always provide follow up work to my freelancers as I have countless projects ongoing (so please think of this when place bids). Make sure you also take the form through every step to understand fully the job you are bidding on; sample links etc to previous work would also be great. Look forward to your responses.

Skills required:
HTML, Java, jQuery / Prototype
About the employer:
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.

$ 257
in 7 days
$ 206
in 3 days
$ 700
in 30 days
$ 144
in 3 days
$ 226
in 3 days
$ 195
in 4 days
$ 191
in 3 days
$ 200
in 3 days
$ 144
in 3 days
$ 155
in 3 days