256789 Registration Form in PHP

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Bids
1
Avg Bid (USD)
$10
Project Budget (USD)
N/A

Project Description:
I need a Registration form to be created in PHP, so I can just drop the form code into my website, and drop the .php form in the web folder to allow form to work.


The form will need the following:

MALE/FEMALE Choice Box
FULL NAME Text Box
LAST NAME Text Box
EMAIL Text Box
CONTACT NUMBER Text Box
AGE Choice Box
D.O.B. Text Box
HEIGHT Choice Drop Down In Feet and Inches( 5.11"
BUILD (S/M/L) Choice Drop Down Small Medium Large
WASTE Choice Drop Down in inches
INSIDE LEG Choice Drop Down in inches
CHEST(MALE) BUST (FEMALE) Choice Drop Down
HOUSE NUMBER AND STREET Text Area
TOWN/CITY Text Box


POSTCODE Text Box

NATIONALITY Drop Down choice of each country
DRIVING LICENSE Y/N Choice Box
DRIVING OFFENCES (please state) Text Area
OWN CAR Y/N Choice Box
NATIONAL INSURANCE No 9 empty boxes for each character
SELF EMPLOYMENT REF Text Area
DISTANCE WILLING TO TRAVELIN MILES Choice Frop Down 0-5 5-10 10-20 etc
EXPERIENCE (LAST 5 JOBS) 5 Text Boxes


SPECIAL SKILLS (eg languages,
juggling,sport skills)

Text Area

When the form arrives in my inbox I want it to Read in a nice looking order

Bold Title

Staff Registration Form

With each Subject in Verdana Font Bold with the inputted text in regular.


Name ( Bold) Joe Bloggs (Regular)

Thanks for reading, its quite an easy job, if you can do php, im just a designer.

Skills required:
Anything Goes, CSS, PHP
Hire willva
Project posted by:
willva
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