Php Form - Html Email with only filled out Fields to be sent

This project was awarded to davemartin for $30 USD.

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Project Description

For a local Bakery, we need a php Form listing about 60 baked goods. (Simple Order Form - no Checkout - no Client Validation)

Form Facts:
- The Form does have 2 required Fields - Name and Email (Javascript Form Validation - Jquery or similar)
- Form should be secured with ReCaptcha + if ReCaptcha fails Form Fields should NOT be resetted (Optional, but preferred)
- All Baked Goods Input Fields are optional, and only numbers are allowed
- On positive form submission the form should redirect on a Thank you Page (possibly with the User entered Data)
- Then the Form should send a Html Email to the Bakery, with ONLY the bakery goods filled out by the Client
- A seperate Html Email should be sent to the Client (same functionality as Bakery Mail, but with different Text)
- Optional, but nice to have: All submissions stored in database

As you can see, it is a simple Form, the only challenging part is that only filled out goods should get send in the Email.
In the Form all Goods, will be displayed with an Image, if possible, in the Email, all goods ordered should also have the image linked to.

Something like:
<?php if ($Rolls) : ?><div class="goods"><img src="remote_host/[url removed, login to view]"><span class="header">Rolls:</span><span class="count">$Rolls</span></div><?php endif>

Your Part:
You will need to provide us a sample Form, showing the Functionality above, but you do not have to create the whole Form, You only need to create a couple of "Bakery Goods".
We will extend the Form later to our Needs, but the Script needs to be completly provided by you with the above functionality.

Preferably we would like a standalone PHP Script.
If this is not possible, Form Frameworks from CMS could be used, but as they require the whole CMS to be installed this is not a preferred option.

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