Make Simple Lead Capture Page

This project was awarded to fachauy for $30 USD.

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Project Budget
$30 - $250 USD
Total Bids
Project Description

I need a simple Lead Capture Page just like

the one in this attachment.

It is a very basic page as you will see.

I will the the email code into the email box.

The winning bidder will be chosen on Competitive bid like $30.

See attachment. Make exactly like you see it except take out name at bottom and "extraneous" code.


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