Fancy, pretty PHP contact form

This project was awarded to GFsoul for $30 USD.

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Project Budget
$30 - $250 USD
Total Bids
Project Description


I would like a fancy/pretty PHP contact form with ajax validation. Fields as follows:

How did you hear about us? [text field] (watermarked Google)

Occasion [text field] (watermarked Wedding)

Event Date [text field / text field / text field] (watermarked DD / MM / YY)

Start Time [text field : text field : text field] (watermarked 7 : 15 : pm)

Finish Time [text field : text field : text field] (watermarked 12 : 00 : am)

Venue Name [text field] (watermarked Wick Farm)

Venue Location [text field] (watermarked Bath)

Is access via stairs? [Yes/No radio]

Title [text field]

First Name [text field]

Last Name [text field]

Email Address [text field]

Daytime Telephone [text field]

Evening Telephone [text field]

Prefered Contact Method [Telephone/Email radio]

Additional Information [textarea]

All fields except Additional Information are required.

The submitted form should be emailed to me.

Awarded to:
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