In Progress

PHP, CSS & JAVASCRIPT PROGRAMMER/CODER

Not a very big project this, but an opportunity to make $100 (USD) for a couple of hours of work...

- I have a main page called '[url removed, login to view]'

- I have a file called '[url removed, login to view]' which contains 'form1' , This file (i.e. [url removed, login to view]) is called inside '[url removed, login to view]' using 'IFRAME' and is also used independently.

- The elements of 'form1' are:

* fname (textbox), # only aplhabets allowed

* lname (textbox), # only aplhabets allowed

* procedures [multiple select list with options 'knee', 'hip', 'shoulder', 'cancer', 'cardiology'] [size='4'],

* sex (two radio buttons),

* age (textbox), # only numbers allowed

* phone(textbox), # only numbers allowed

* email(textbox), # only valid email ids allowed

* reemail(textbox), # should exactly match email entered by the user

* query(textAREA)

* attach(A button to upload/attach files. The file can be .doc, .pdf, .txt, .jpg, .bmp, .png, .psd)

* A CATCHA IMAGE GENERATED BY A PHP FILE CALLED '[url removed, login to view]'

* security_code(textbox), # should exactly match the image generated by '[url removed, login to view]'

* send(submit button)

All the fields except 'attach' are REQUIRED and cannot be left blank.

All the fields need to be validated before the form submission can go through.

In case of an error the error needs to be displayed and the input field with error needs to get the focus. Also in case of an error The form needs to hold the values already entered by the user and the data already entered by the user should not be lost. The field with error receives the focus (i.e. gets the cursor). For all incorrect fields the background turns red and a line saying 'invalid input' needs to be displayed in RED under each invalid/incorrect field. For all the correct fields the background turns green and a line in GREEN saying 'input seems to be valid' needs to be displayed under each valid field.

When all the fields are valid ONLY then should the form submission go through AND THE VALUES OF THE FORM NEED TO BE MAILED TO MY EMAIL ID... (along with all the SELECTED values of 'procedures[]' multiple select List box)... A Success message/Line needs to be displayed at the top of the form... The values of the form need to be RESET...

At NO point in time should the user be redirected to any other page. NO new windows should open. All the validations, submission, error, success messages,etc. need to be displayed while staying at the same page. All scripts to be executed on the same page...

The php file for form validations and mailing to be named '[url removed, login to view]'...

Style Sheet for main page '[url removed, login to view]' is '[url removed, login to view]'

Style Sheet for '[url removed, login to view]' (i.e. the page that contains [url removed, login to view]) is '[url removed, login to view]'...

Skills: AJAX, CSS, Javascript, PHP, Website Design

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About the Employer:
( 1 review ) Nagpur, India

Project ID: #1069373

Awarded to:

easycoders

Hi, Please check your inbox.

$47 USD in 1 day
(46 Reviews)
5.9

26 freelancers are bidding on average $74 for this job

SiliconMind

Kindly Check PM

$70 USD in 0 days
(89 Reviews)
7.0
rudraraj

Please select to start..

$100 USD in 2 days
(115 Reviews)
6.5
updatedversion

Please check the PM for details....

$90 USD in 1 day
(50 Reviews)
6.5
prominentsoft

I can get it done and ready to start right away. More on PMB.

$100 USD in 1 day
(90 Reviews)
6.2
mohanchauhan

Hi Sir, Please check pm. thanks

$50 USD in 1 day
(25 Reviews)
6.2
cristisst

please read pm for more details

$100 USD in 0 days
(108 Reviews)
6.2
ttmtake

Hi, i send you PM.

$100 USD in 1 day
(40 Reviews)
5.9
VikashThecoder

Please see details

$50 USD in 1 day
(100 Reviews)
5.5
itambassadorz

Please check PMB

$40 USD in 1 day
(20 Reviews)
5.0
Marksimson

Ready to start this work right now. The project will be done according to your demands. Read pm for more details.

$100 USD in 2 days
(10 Reviews)
4.8
topscripter

Hello I am highly interested in ur project. Please check PMB.

$50 USD in 1 day
(23 Reviews)
4.7
DTeam

Hi, ready to start, let me do it for you, thanks

$99 USD in 2 days
(10 Reviews)
4.3
smartskill

hi LETS START NOW!!!!!!!!!!!!!!!!!! i m a php mysql developer haveing 5 yrs work experience area of experience 1. magento 2. wordpress 3. smarty 4. ajax etc. Check PM for details

$100 USD in 0 days
(6 Reviews)
3.4
edsonnlb

Experienced developer. Check PM please.

$50 USD in 1 day
(2 Reviews)
3.3
ianreynolds

Sir, choose me for this project and you will promptly receive form validation code, both client- and server-side, that will be so beautiful your eyes will well up with tears. Please see my PM.

$60 USD in 0 days
(2 Reviews)
3.3
AravindSrivats

Hi, I am interested in finishing this project. PM for more details.

$90 USD in 1 day
(1 Review)
3.2
ciupacazette

check you pmb for details

$100 USD in 0 days
(2 Reviews)
2.3
Arbab64

Dear Sir/Madam, I'm a certified ASP.NET developer and can develope applications from scratcth to complition, and I'm very interested in your job post involving these skills. I have recently worked on a project More

$30 USD in 1 day
(0 Reviews)
0.0
webmaster4

Hi, I am a designer cum developer using PHP and CSS . I have developed so many similar works having Form Validations using Regular Expressions . Also worked in CAPTCHA images. Implemented file uploads in my works. Hand More

$60 USD in 3 days
(0 Reviews)
0.0
WebWoodo

Hi, i'm new here, that's why i'll make a good ajaxed form, with jquery, animation and server side backend, with all validations are required. Please contact me as soon as possible. Thanks

$90 USD in 1 day
(0 Reviews)
0.0