In Progress

Create a questionnaire form in html5

Your mission if you choose to accept it will be to create a customized contact form and adding it to an existing html based webpage.

Ideally this would accomplished using this, which I already own : [url removed, login to view]?

The contact form will include

2 hidden fields that will be populated by data passed from an aweber based opt-in page for users names and email addresses

2 drop down fields asking users what style of house they are looking for and how many bedrooms they need

Lastly 3 text fields

I need to be able to dictate which email addresses the form will be sent to when its filled out and when the form is completed you will create a quick tutorial either through screen recorded video or with screen shot images how I can add or change questions and email addresses the form is sent to.

Thank you!

Please write the word Apple in your bid description so I know you've read the project details entirely.

I need to assign this project quickly..

Skills: Electronic Forms, HTML, HTML5

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About the Employer:
( 12 reviews ) Oakville, Canada

Project ID: #4148457

Awarded to:


quick pro help. ftp and milestone required.

$35 USD / hour
(55 Reviews)

5 freelancers are bidding on average $29/hour for this job


"Apple". Quality work assured. Ready to get started. Thanks.

$60 USD / hour
(43 Reviews)

I would like to start today. I can probably finish same day. May you please PM to me your host's platform, like linux or windows, and if you are on a shared or vps plan?

$15 USD / hour
(5 Reviews)

Hi, Veltrod Software services is a global software consulting company specialized in providing Mobile applications, Social media frameworks and eCommerce solutions. Leveraging best-in-class people, processes, and te More

$20 USD / hour
(4 Reviews)

"Apple"! - Applying a ready-made template to a website is simple enough and then going onto customize it should not take too long. I look forward to working with you.

$16 USD / hour
(0 Reviews)