question bank display

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Bids
21
Avg Bid (USD)
$134
Project Budget (USD)
$30 - $250

Project Description:
we need a submit question popup page with following information :

name, designation, city, question

We dont need to use any database to store and display this messages. Its a online session where viewers can click on question button and popup should come out with following fields - name, designation, city, question

and once user submit this, this info should be display to admin on a browser

Skills required:
.NET, ASP, HTML, Website Design
About the employer:
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