create a form

This project was awarded to binarygeotech for $30 USD.

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Project Budget
$30 - $250 USD
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Project Description


check attached what we need.
you will have to create a form in php/html5/css in french and english (the client will have the choice to select his language and all the process will be in his language).
by sending the form it will generate a unique reference number in email sent to the both part.
also design a little bit the form in css to be a clean and pro form.

budget: $30

thank you.

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