HTML/PHP form fix needed

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I need an experienced coder to do a quick troubleshooting and fix PHP form. The form is a user account application form

-There are currently issues with submitting form and some users get blank form submission page (javascript and php issues)

- Form need fields to be validated properly e.g check email address, address, phone number etc

- add captcha

- Improve and fix any issues on form and form admin panel (for viewing completed forms)

- improve form including accessibility by attaching appropriate tags etc

Need someone that can start immediately and can discuss details online if needed.

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