PHP Contact form update

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Bids
17
Avg Bid (USD)
$64
Project Budget (USD)
$30 - $250

Project Description:
Hi I have a PHP contact form that I need updated with the following things.

- Email output needs to display in a grid or boxed format similar to that of the website so that it is easy to read, blank entries will also need to be filled with a '-'
- Date field needs to be changed to a drop down date menu
- 'Email' field removed and replaced with another content field (same as the others)
- Additional field at the bottom of the form
- Form to reload and show successfully sent message and wipe all the filled in fields once email is sent
- all titles on the left to be able to use a JS popup/tooltip module to display text/image when mouse hovers over.

This will need to be completed ASAP

Skills required:
AJAX, Engineering, MySQL, PHP
Hire tyfive
Project posted by:
tyfive Australia
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