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HTML contact form coding

This project received 7 bids from talented freelancers with an average bid price of $69 USD.

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Total Bids
7
Project Description

I am developing a new website geared toward collecting new subscribers. I need someone to code the contact form (so I can use it on any website in the future). The form should send the new subscribed information to a database. The form must collect the originating IP address from which the person filled out the form and also include the following fields:

Email
First Name
Last Name
Address
City
Zip Code
Phone

Should be a simple enough job for someone...

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