Simple Mail Order form (1863164)

Description: I want an order form in which there are 3 specifics through which the amount will be accumulated and 1 optional that is the discount field, then total will be shown in a span on the page and once submitted the user will be forwarded to SWREG checkout page, after the payment page user will be forwarded to a thank you page on our website and the data inputted by the user will be mailed to an email address of my choice. ## Deliverables No designing required: The order form is designed completely and just lacks the functionality aspect. No. of Fields/data to be sent to a prescribed email and pushed to calculate amount: 6 text fields 3 Select boxes 1 text area 1 check box button 1 submit button No. of Fields/data to be used to calculate transaction amount and forwarded to merchant after submit 3 Select boxes 1 Text field + 1 optional discount field How the order form should work step by step: Personal information 1. User Enters name 2. User Enters Email 3. User Enters Phone Order information 1. User Enters Website address (Not required) 2. User Chooses service (Select: Dropdown) When the user chooses a particular service he will be given the specific grades in next/following field. There are 4 grades, some of the options in the dropdown box have 2 grades some have 3 and some have all 4. So when the user chooses for e.g.: All grades; all grades will be shown in the next dropdown box below; if Show 2 grades; only 2 grades will be shown below. 3. User Chooses Grade Each grade have a different price, so the options above will give show the applicable grade from which the user can choose which one applies to him/her) 4. User Chooses Range A particular grade contains a unit value for e.g.: 0.015 - entry grade; if a user chooses entry grade and puts chooses 100+ from the range box the total value will be 100 x 0.015; which will be further multiplied in the second last field which is of quantity) 5. User Enters Quantity now the user choices above will be multiplied from the no. of quantity inputted by the user. So in a nutshell: This is what is happening: A user chooses a service > That service have 2-4 types/grades /levels each having a unique unit price = User chooses grade> User chooses word range > User chooses the quantity of the number of project he/she requires. So the formula will be: Grade unit price x word range x quantity = Total price - by optional discount 6. Last is the order details that like the rest of the form fields will be emailed to a prescribed email of my choice. 7. There will be a discount field. The user will enter a code and a discount will be applied along with showing in span some description about the discount. No need of databases, you can make a php file and put the codes there, it should also have an option to deactivate a coupon code or not applicable anymore in the php form so the coupon cannot be used after a certain date or whatever requirements our promotion might be for the code. 8. Terms and condition Agree checkbox(required) 9. Current Order total value box This is a span in which I need the total value before; so the user can confirm the amount before going to the next page. 10. Submit button a.) Finally once submitted the user will be forwarded to the payment page b.) After successful payment, the details inputted will be emailed to a prescribed email and the customer will be sent to thank you page on my website. This project is very simple and can be done within an hour. I need this done as soon as possible, by an expert programmer as I want the code to be as less as possible. Please bid reasonably. Any more ideas you may have please discuss before bidding, once selected we will go exactly the way SRS has been set before the acceptance of the current project. Note: Payment will be transferred after the order form is fully functional and tested thoroughly by us for 48 hours. Items provided: 1. Domain & hosting information, 2. Testing Email, 3. Checkout merchant.