Need a Website built

Avg Bid (USD)
Project Budget (USD)
$250 - $750

Project Description:
I need to build a website were the user enters their zip and after they enter their zip code, they get directed to another page which they fill out a small form. The form they fill out needs to be emailed to my email. Pretty simple task, I have a website as an example.

Skills required:
Graphic Design, HTML, PHP, Website Design
About the employer:
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