A One Page insertion form in php/mysql

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Bids
29
Avg Bid (USD)
$65
Project Budget (USD)
$30 - $250

Project Description:
I have a one page form which is already designed. The insertion part has to be done using php. There are 3-4 sub insertions associated with the main form.
This work has to be done in 4 days of awarding the project.
The code should be optimized and clean.
This form is just a part of a bigger project.
If the work is good, the entire project will be given to the freelancer... which may require 3-5 months of regular work.
Just quote the cost of a single form insert, the form has around 18-20 fields, and 4 subinserts with 3 fields each. The database is in sql

Skills required:
MySQL, PHP, Software Architecture
Hire myDesignFactory
Project posted by:
myDesignFactory India
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