Minor changes on a submit form

In Progress

Right now, the form looks like:

[url removed, login to view]

We would like:

1) The top part of the form to have "Personal Loans" and "Student Loan Debt" removed

2) The bottom of form, instead of the slider, have check boxes, starting at $5k-$9,999 and then $10k-$19,999 and so on up to $100k and then $100k+

like you see on [url removed, login to view]

3) When submitting from slider on home page to this form, the checkbox should be checked for most appropriate debt amount (e.g. if someone goes to page [url removed, login to view] , the $50k debt range would be automatically checked

4) Change title to "Finish Getting Your FREE Confidential Savings Estimate"

Please confirm you can start today and finish today.

Thank you!

Skills: Graphic Design, HTML, PHP, Website Design

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Project ID: #4351127

Awarded to:

arel

Please check PM for a WORKING DEMO of your form!

$35 USD in 1 day
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5.4

22 freelancers are bidding on average $31 for this job

wpdreamersl

Hello mate! Please check private message!

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6.9
kssoftphp

I am ready and expert in PHP and MySQL.

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agarassino

I can take this today and finish it asap, it is an easy task, please check my reviews. Thanks!

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5.1
samkaranja

Hello, after reading the your description i got interested in working on your project. I will offer quality work within the deadline.

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5.1
thetechrise

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abanipatra

Hi, I would like to work on your project. Regards Abani

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jaisnikhil

Hi There! Its the minimum bid I can dot. Thanks

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shuvrapan

I can do it today.Please check Pm.Give me the project file.

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4.1
Locust

10 minutes job for a good designer. :)

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3.8
niravvirani17

Ready to start now and also finish today

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3.5
Tulear

Just award me this project and consider it done ! You have a real professional here, ready to make you happy. Thank you.

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3.1
lexmat

Dear Sir, i have 4+ years experience. please see PMB Thanks.

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3.0
nicewebtech

Quality work assured. Ready to get started. Thanks.

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3.1
webley

Hi I can do this. Looking forward to work with you.. Thank you..

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sumithharshan

Ready to work sir.Please check your inbox.

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2.4
codejamer

Ready to start right now...........please consider my bid.......

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axxwee

I have 3 years experience as web developer.I can start right now and finish in a few hours or less.Best regards,Radoi Alex

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LROC

Dear Sir Graphics Designing, Logo Designing, Website Designing & Development 9 years Expert here.We read & understand your project requirement. We are really interested and ready to start work in your project. Please c More

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LunguAndrei

Hello! I would like to work with you on modifying your Debt Relief Form. Please have a look at your private message board. Thank you!

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1.2
murad288

Dear, i can finish this job today.

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