PHP payment form

Closed

Hi, I need to create a simple form to allow my customers to choose how they would like to be paid.

I would like users to be able to choose from a pull down menu the payment method. Once selected a form is shown for that particular payment method. When the form loads it should automatically switch to the current payment method.

The payment methods are...

1. Check

Name to print on check.

Address line 1

Address line 2

Address line 3

Address line 4

Country

2. Check sent via Fedex

Same form fields required as check.

3. Payoneer

No form fields required just a save button.

4. Direct deposit

Name of account holder

Bank name

Routing number

Bank account number

5. International wire

name of account holder

Bank name

IBAN

BIC number

The form needs to be checked for valid data. Check all required fields contain data and it is in an appropriate format. I will take care of the css, design and mysql integration. I just need the basic form layout, css/javascript to make the form work and the php file to verify the data.

Skills: Electronic Forms, Javascript, MySQL, PHP, Software Architecture

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Project ID: #4474430

Awarded to:

frkSuna

I can do it quickly. Please check PMB

£60 GBP in 1 day
(111 Reviews)
5.9

20 freelancers are bidding on average £105 for this job

phpexp

Your requirement is clear to me and i can make the payment form as per your requirement efficiently. I am ready to start. Please check the PMB.

£139 GBP in 7 days
(169 Reviews)
7.8
w6d

PHP experts here. Get this done within 24 hours.

£100 GBP in 3 days
(143 Reviews)
7.4
coolguyinus2004

Validation check in PHP with all required fields correctly done via Ajax scripting and PHP.

£257 GBP in 3 days
(274 Reviews)
7.3
graphicaa

Hello sir, please check PM

£139 GBP in 3 days
(113 Reviews)
6.8
netxpertindia

We will develop this form based on payment methods

£115 GBP in 3 days
(80 Reviews)
6.7
ranganalx

Hi, good day! Let me do this. I'm very well versed in PHP and can deliver this in no time. Hoping to hear from you. Thanks!

£128 GBP in 7 days
(247 Reviews)
6.4
dinotech

understood your requirement and ready to start..................

£139 GBP in 3 days
(39 Reviews)
6.2
marketingzone

Kindly check pm to get an attractive bid

£110 GBP in 10 days
(45 Reviews)
5.6
VaniaTech

We specialize in web design and development , please refer to pmb for more details. Thanks

£98 GBP in 2 days
(7 Reviews)
5.2
miniric3

Hi, our team of professionals at on2itonline would love to work with you on this project. Please check out our great feedback on some of our other staff profiles here; Check out our crazy cool style on our previo More

£257 GBP in 10 days
(5 Reviews)
4.9
farhaoui

HI, READY TO START WORK. LETS START AND FINISH IT ASAP. I HAVE 8 YEARS OF EXPERIENCE IN WEB DEVELOPMENT FIELD ( PHP, MYSQL, AJAX, JQUERY, HTML, CSS... ). THANK YOU !!

£55 GBP in 3 days
(46 Reviews)
4.7
mindprogram

PHP and jQuery/CSS forms expert here. I can do this for you perfectly with server side validations via AJAX.

£88 GBP in 1 day
(19 Reviews)
4.5
cptechnology

Hi, We ready to start the project immediately. cheers, Joshua.

£38 GBP in 3 days
(21 Reviews)
4.6
TGLServices

Very experienced and can have this done within the hour - UK based

£88 GBP in 1 day
(3 Reviews)
4.0
ronnyinfo

Hey there, I can code your form until tomorrow. Cheers!

£88 GBP in 3 days
(16 Reviews)
3.9
Mohsen6558

I'm PHP expert and ready to start

£73 GBP in 1 day
(7 Reviews)
3.9
jasqwerty

Hey, this sounds like a fairly straightforward project. I could have it knocked out pretty fast. One thing is do you have a dataset set to match bank routing # to bank names or is that not a check you're worried about?

£44 GBP in 1 day
(7 Reviews)
3.8
asoftech

Hello, How are you? I see the requirement and I can make this project. Can you check my portfolio for some time? My portfolio is: http://www.assoftech.com. Kindly check my work details in pmb.

£148 GBP in 3 days
(4 Reviews)
3.6
praveen458

Hello,I am a javascript and php programmer.I can do this job,please look at my message for the information of form layout, validation and other details. thanks,praveen

£25 GBP in 2 days
(10 Reviews)
3.5
enriquethumar

Hello sir,(check PMB) We have very good experience in web fields, our experties are PHP ,MYSQL ,WORDPRESS ,javascript ,PAYMENT GATEWAY ,JQUERY ,MAGENTO ,DRUPAL ,JOOMLA ,Ext JS ,ZEND FRAMEWORK ,ZEN CART ,V-BULLETI More

£55 GBP in 1 day
(2 Reviews)
3.5