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Browser plugin help - Javascript

We are looking for someone to help us create a bookmarklet, which we think is a browser plugin. Please see attached file. We'd like something similar to this. Specific fields will be given after the acceptance of project. But it's a simple form similar to this example.

The bookmarklet will also need to interact with our site and our database.

We appreciate the help!

Skills: AJAX, Javascript, MySQL, PHP

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About the Employer:
( 0 reviews ) United States

Project ID: #4251830

8 freelancers are bidding on average $331 for this job

annsys

Hi Send me the files. I am ready to start. Thanks Jack

$600 USD in 10 days
(88 Reviews)
5.6
Eliteprog

Hi, First of all thanks for posting this project, I am available to provide you economical services for development of browser plugin, I have read and understood all of project details. I am expert in web developme More

$200 USD in 12 days
(22 Reviews)
4.8
thesmartdigitals

Hi, Web Developer And Coding Expert, Ready To Create The Required Form As Needed

$1200 USD in 10 days
(6 Reviews)
3.6
tourala

Hi! I've read your project description, and I have the required skills on AJAX, Javascript, MySQL, PHP to complete the tasks of project. If you have anything to ask you can please. I have expertise to meet your proje More

$222 USD in 6 days
(3 Reviews)
2.3
benashton

I'd love to work on this project with you. Please see my PM for more details

$150 USD in 5 days
(1 Review)
1.6
parveen2505

Ready To start now....got your requirements....plz read the private message

$50 USD in 4 days
(1 Review)
1.0
vivekjustthink

Hi, happy to do this for u. Looking for your acceptance soon..!!

$250 USD in 5 days
(0 Reviews)
0.0
svoyski

Ready to help. Please see the sample application referenced in the private message.

$100 USD in 2 days
(0 Reviews)
0.0
munzirbm

I have experience in making bookmarklets

$100 USD in 15 days
(0 Reviews)
0.0