Custom Contact form with ajax/jquery

This project was awarded to zarish for $25.5 USD.

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Project Budget
$30 - $5000 USD
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Project Description

I am looking to have a custom contact form created based on the attached image.

Please notice that regular form fields have been replaced with images. Also please notice the "characters remaining" function.

You will be responsible for creating the working form as well as the send function.

I can provide a PSD file to make development easier.

I need this to use jQuery/php.

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