insurance website

This project received 50 bids from talented freelancers with an average bid price of $19 USD / hour.

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Project Budget
$15 - $25 USD / hour
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Project Description

Create a form submittal website in php, 15 fields, java form validator for all 15 fields, header to incorporate pull down menus, css control over most of the color and design. must be very professional looking. Design experience is crucial. I will show examples of my design requirements. Layout requires: header [6 drop down menus], left-menu, body (, right-menu, sub-footer, footer, I will need to see examples of your work. Must work in all major browsers.
examples of style required
[url removed, login to view] - i like the form position on this site
[url removed, login to view] - content provided here
[url removed, login to view]
[url removed, login to view] - very nice layout and color

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