Website Form - repost

Budget $10 - $30 USD
Bids 9
Average Bid $94
Status Closed

I need a form that will allow users to select a category, years of coverage, then the submit button will take the user to a page to purchase the plan based on the category. There will be approximately 8 combinations. I will provide a PSD layout of how the form is suppose to look. The copy will be dummy copy due to the confidential nature of the project. In turn, I will need a commented HTML file as well as supporting css and javascript, so I can update with the appropriate copy and links.

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Bids on this Project

  • kZLOYhjzNkkQ Profile Picture


    Adana,  Turkey


  • templatesale Profile Picture


    Coimbatore,  India

    I am KrishDD, for your professional Design and Development Needs. I can manage with all kind of logo design, graphic designs as brochures, flyers, Business cards and all kind of Print Designs. Also I can manage with All kind of photo manipulation, image clipping, photo background removal, image retouching, and image resize for shopping cart sites and more image and photo edit solutions. Not only i am expert in design, i can do all kind of Responsive HTML/css, Boostrap, and also a All kind of CMS, like wordpress, magento, ecommmerce, shopping cart sites and blogs and more custom websites with custom php as well. To know more about me, please check my client reviews here. Please send me a private message to discuss further and start your work. Thanks for your time to reading about me. Welcome for discussion..

  • zaluma9 Profile Picture


    pasuruan,  Indonesia

    saya bisa ngleyout web

  • pixelke Profile Picture


    Temerin,  Serbia

    I am an experienced developer looking to be hired. In my work experience I have versatility as a Graphic Design Artist working on many different projects. I also have exemplary skills in the areas of HTML, CSS, PHP, MySQL, Javascript and jQuery. You can trust on me for any of your assignments and I will deliver the result in a prompt manner. I can help you with: • HTML, CSS, PHP • MySQL • Javascript, jQuery • Photoshop, Illustrator, InDesign Service Guarantee: I provide free support up to 24 hours after project finalization for any fixes or software I have made for you or free revisions of designs created.

  • webtrendz Profile Picture



    Webtrendz Technologies India Pvt Ltd is rapidly emerging as a premier offshore web development company in India. We have the expertise to make your communication and transactions on the internet effective. We ensure this through appropriate content and suitable internet tools, sufficient enough to reach far and wide markets. Webtrendz services leverage deep domain expertise in the Industry, technical expertise in leading Internet technologies and a cost-effective global solutions delivery model. The services are provided under the aegis of our communications and e-business practices. At Webtrendz India, you can shop for an array of web based services and development support, which may include consultation, website development and maintenance. With an excellent track record in the global market and our presence in the domestic market is equally laudable.

  • Cfurku Profile Picture


    kallithea,  Italy

    PHP / MySQL developing Javascript / jQuery HTML Web design WP plugins

  • juicycherry Profile Picture


    Sydney,  Australia

    PHP 5, HTML, JavaScript, CSS, jQuery, Ajax, MySql, Drupal, Wordpress, Joomla, Google AdWords, Google Analytics, SEO, HTML 5

  • tcsvnn Profile Picture


    Go Vap District,  Vietnam

    1. Vision: - Training and development of human resources. - Cooperation manufacturing and processing software products. - Implementation of the domestic and international links in the IT's industry. - Implementation of integrated IT's systems. 2. Mission: - Provide the optimal solution that maximize the benefits of stakeholders. - Honour the unique creativity and innovating technology. - Assure the products and services quality with unique features. Overview: The company was founded at the beginning of 2012, based on its precursor as NQSolutions company, by a team of enthusiastic and experienced IT specialists, TCS provides services and solutions that increase the benefits of customers in domestic and international market. With the philosophy of business “Optimal solutions – Awesome features”, TCS provides its customer professional consultant and the best services in IT industry. After two years of operation, we have developed series of products and solutions and gained various experience in services we provide: Software Development, E-Commerce Solution, E-Education Solution, Web Development, Project Recovery, Mobile Applications… Our experts have brought the complete satisfaction to customers all around the world through providing the software development services, from individuals, small business to large business. Up to have, we achieved the remarkable achievements from different projects. We always seek to provide the better and better service to our customers, and we’re always ready to receive and appreciate all the feedback from customers.

  • phongpp2000 Profile Picture


    Binh Duong,  Vietnam

    I have worked with php and mysql 5 years. I can work good with php,ajax,jquery,sql. I also work with opencart,prestashop and wordpress Our team can do very good with wordpress. Please look some websites which we already done for wordpress.