Write Sourcecode for a Contact Form

  • Status: Closed
  • Prize: $100
  • Entries Received: 3
  • Winner: bertlprinz

Contest Brief

I need a 2 Steps contact form where the data is saved in a MySql DB using php and jquery
First step:
- Salutation (Mr oder Mrs) whith a checkbox needs to be determined using Radio buttons and saved in the db.
- First name needs to be determined and saved in the db.
- Second name needs to be determined and saved in the db.
- E-mail needs to be determined --> there has to be a check if the email is valid and saved in the db.
- Checkbox for confirming the rules of the webpage needs to be at the form --> if the checkbox is not marked the user can't go further
- Continue Button
--> All Fields are obligatory, if a field is not entered a message should pop up which informs the user. If the email is inavalid also a message should pop up
Second step:
The webpage where the form is embedded shouldn't change only the fields in the form need to change.
The form should now show the following fields which also need to be stored in the db.
- Street
- Number
- zipcode
- City
- Phone Number
- Country (drop box where you can choose three countries)
- Birthdate (a field for day, a field for month and a field for year)
- Button Submit

All the data needs to be stored in a db and in addition an email to the user where he can confirm his input (via a confirmation link) needs to be sent. This also has to be stored in the db.

--> lookup wireframes in the attachement

Recommended Skills

Public Clarification Board

  • sachinmjagtap
    • 10 years ago

    I think it will be more convenient for user to interact with the form.

    • 10 years ago
  • sachinmjagtap
    • 10 years ago

    Hello sir,
    I can work for you...

    • 10 years ago
  • tacuong2806
    • 10 years ago

    Easy job. Only step-by-step to save register data.

    • 10 years ago
  • soumyadeb
    • 10 years ago

    This is an easy job for us. I checked both of the two interfaces and does make sense. Ready to start.

    • 10 years ago
  • RS Software
    RS Software
    • 10 years ago

    Hi, I am one of the top ranked php developer in freelancer.com. I can assure best quality and result. let me know. Thanks

    • 10 years ago
  • daviddevp2013
    • 10 years ago

    I am having more than 6 years experience of working as a web developer and having a great exposure of website designing and Development in PHP, MySQL and Open Source Technologies like worddpress, oscommerce, zencart, Magento etc. I have developed many projects using MVC Framework like Zend,Smarty,CodeIgniter and CakePHP. I can do a project from scratch to final Phase.I believe in quality and client's satisfactions. I have worked on many various national and international projects.

    • 10 years ago
  • allroundexperts
    • 10 years ago

    Hey , i can start immidiately , Please post a project for this !

    • 10 years ago
  • yogeshsharma89
    • 10 years ago

    Can the warning messages be shown in colored labels in right side of fields, instead of popup ? I think it will be more convenient for user to interact with the form. Please tell.

    • 10 years ago
  • hellouniverse
    • 10 years ago

    Hello. Would you prefer styling or plain HTML?

    • 10 years ago

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