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Dynamic Registration Form

This project received 20 bids from talented freelancers with an average bid price of $518 CAD.

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Employer working
Project Budget
$250 - $750 CAD
Total Bids
20
Project Description

Create a registration form with dynamic elements for class registration. Form also has to collect Credit Card details securely*.

The form needs to be able to securely transmit the data so that the information can then be printed in a reader-friendly way. The user should be able to review the data/registrations before it is submitted to confirm accuracy and the form should also email a confirmation to the user saying the registration has been received.

Please see attached files for a rough HTML example as well as a word document outlining the fields required.

The form will be set up on a subdomain of my website and hosted on a server with an SSL certificate.

*Currently the payment processor is Beanstream which supports Tokenization aka Secure Payment Profiles in order to collect the Credit Card information without charging the card any amount. We need the ability to manually charge the customer after registration. Please see link below as a resource for PHP integration to create Secure Payment Profiles:

[url removed, login to view]

I am open to integrating with another payment processor or service (Stripe seems to have this same ability) in order to accomplish this if there is a better way. Currency is Canadian.

The form does not have to look nice. I will add styling myself.

Please outline in your bid how you would make sure the information is secure and what payment processor you would integrate with.

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