Custom Sign Up Web Page Form e-sign & Design Graphics

Cancelled

Description

Please see attached picture.

I am looking for someone to build a custom Sign Up Web Form & that knows how to design. I need a template to put on clients site so the coding has to be written and given to me with an example of it live (hosted on your site).

As you see in the picture, I would like the following information:

-First Name

-Last Name

-Email Address

-Postal Code

-Language of Choice Option

-Check off box if user wants to receive emails from xyz company.

-French Version of sign-up form.

Mobile number field is already taken care of as it will be connected through an sms platform. I need someone who has experience in this and is a pro/expert. I need you to explain to me some things, where the information will go & how it is collected.

iPhone Image: I would need an image of an iPhone similar to the one shown in the picture so that the sign-up form can go inside of.

PLEASE SHOW ME PAST WORK when you message me. No down payment, I will pay in full after project completion. Thanks for your interest and hope to work with you soon!

Skills: CSS, HTML, PHP

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Project ID: #4454176

6 freelancers are bidding on average $54 for this job

esolzsales

Kindly check the PMB for a more detailed message.

$53 USD in 2 days
(256 Reviews)
9.5
linuxfreak1985

Hi there, We are experts in PHP Open Source (any kind of PHP/MySQL work),wordpress and Ajax/Web 2.0 technology. Some of the projects we completed for php are mentioned below https://www.freelancer.com/projects/ More

$68 USD in 5 days
(67 Reviews)
6.0
prissyandchunie

Dear Sir, My name is Prissy, and i have carefully read your requirements. However, can you kindly provide me more information about project. My partner and I are professional website designs by using softwares like Fir More

$55 USD in 3 days
(26 Reviews)
4.3
rvtechsolution

Our main target is to amaze you by our quality works and try to give you a standard website depends on your requirements. Your satisfaction on our work is our great pleasure. We will appreciate if you give us the chanc More

$33 USD in 5 days
(8 Reviews)
3.4
eliaa

i have 3 year experience in web development and design using php,mysql,html,css,jquery.<br>i'm ready to start asap.

$55 USD in 1 day
(2 Reviews)
1.9
sm7

We are a team of SMS and Voice based website Expert Please check our company website: www.snowmicro.com We developed the similar applications before. Please check your PMB

$72 USD in 3 days
(0 Reviews)
5.8
VimalKB

Respected sir,am willing to take up the project.Pls check your private message.

$45 USD in 2 days
(0 Reviews)
0.0