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Php/HTML Email Form

This project was awarded to peruvianmaster for $30 USD.

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Awarded to:
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Project Budget
$30 - $250 USD
Total Bids
4
Project Description

I need a basic Php/html form that I can take the html and drop into my cms application. I want the html to call a custom php form (do not want to use the cms application) to process the form. I want to be able to update the sendto email address as well as include a blind copy BCC inthe php code. Yes, I can update this part. Once the form is submitted form will re-direct to thank you page.

Using Linux Godaddy for hosting

The form needs to contain all of the fields on this form along with associated drop downs and radio buttons.
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Need it yesterday! Thanks in advance.

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