Very Short Survey Form

CLOSED
Bids
22
Avg Bid (USD)
$90
Project Budget (USD)
$30 - $250

Project Description:
I need to create a survey form and following fields will be there:
Date, Name, Address, GPS Coordinates, Gender, Number of Children and then there will be a Process and user has to check radio button to tell about the consequences and likelihood after that it should auto calculate the result based upon the selection and then we will show the level (Low, Moderate, High, Extreme) of that calculated value.
Finaly, we will submit

Skills required:
HTML, Javascript, PHP
About the employer:
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