In Progress

Landing Page (1 Pager) Form Collection of Data


I need 1 web page that will act as a form to collect data from trade shows. The page will be hosted on separate domain which will be used by people at trade shows to sign up electronically.

The information the page will collect is shown in the attachment.

Importantly, the person who does this must know how to

(1) integrate facebook, as 1 of the form options is to like our page and post on their wall a comment.

(2) verify email addresses as valid and data validation to make sure we're getting quality data.

(3) transfer the data collected into a backend module which I can use to extract data in CSV/Excel format.

The successful freelancer should also provide support in assisting me to transfer the site and host it through my private web hoster.

The form itself is quite simple as there are <5 responses required (see attached). Pretty much all of the copyrighting is provided and I'll also provide the successful freelancer with print pages of the website so they can see the design. A simple design is preferred with

Milestone payment can be scheduled however, the final milestone, will only be released upon successful deployment of the page onto the URL.

Please provide previous sample of work you have done if you've done similar things before.

This needs to be completed AT LATEST by 21 April 2013.

Skills: Electronic Forms, Landing Pages, Web Hosting, Website Design, Website Management

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About the Employer:
( 14 reviews ) Yarraville, Australia

Project ID: #4398572

Awarded to:


Check PMB for Details.

$185 AUD in 3 days
(130 Reviews)

24 freelancers are bidding on average $176 for this job


Freshwebsites is a design and web development company, technology services and branding company. Combining unparalleled experience, comprehensive capabilities across the design and development industry and business fun More

$515 AUD in 7 days
(25 Reviews)

please view pm

$206 AUD in 5 days
(136 Reviews)

Thank you for taking time to review our bid. We are certain that we will provide the full suite of integrated solutions required by your company.We have reviewed the project requirements, the requirements match our ski More

$257 AUD in 7 days
(68 Reviews)

Dear Sir/Madam, We always Provide all services such as Web Design & Development, PSD to HTML, PSD to HTML to Wordpress, Graphic Design, Landing page Design, Logo, Banner, Brochure, HTML, XHTML, HTML5, PHP, Word press, More

$257 AUD in 10 days
(81 Reviews)

Hi, Experienced Web Developer here. I can build you the required landing page with a form to capture information from users. I've already done many websites which contains the forms so this is definitely an easy task f More

$147 AUD in 4 days
(53 Reviews)

Hi, our company specializes in web development and design. We can get this project done within your timeframe.

$180 AUD in 9 days
(21 Reviews)

Hi, We are a team of designers and developers who are in this field from more than 13 years. We are a web design and Development Company, providing web development in PHP, CMS based websites, E-commerce website, WordPr More

$204 AUD in 5 days
(19 Reviews)

Hi sir, please check PM, thx Kimi.

$248 AUD in 5 days
(30 Reviews)

I am BEST LANDING PAGE DESIGNER AT INTERNET. More then 5000 landing page Design experience. Please check my designed landing page and I will give you quality work on time. Regards

$128 AUD in 7 days
(11 Reviews)

Hi There, We understood your requirement, I can do this project with proper validations. Thank you Karthi

$103 AUD in 3 days
(14 Reviews)

Hi, We are best landing page/squeeze page designer, please check our landing page work & recent feedback in pmb, Regards

$236 AUD in 7 days
(6 Reviews)

Hi, can do it by the end of the days coz it`s simple task

$55 AUD in 0 days
(16 Reviews)

Hi, We are interested in doing your project. We have wide experience - from simple site for professionals to complex sites with e-commerce, group membership, indexed search functionality, interactive views & gra More

$79 AUD in 3 days
(2 Reviews)

I can give u a good landing page to collect data

$79 AUD in 5 days
(6 Reviews)

Hello, Can create a professional + teaching LP ( form collector) for you and will also help you in transfer. Will be on time as required. 21st April 2013.

$210 AUD in 3 days
(3 Reviews)

i am ready to start now .

$200 AUD in 3 days
(7 Reviews)

Please check PMB

$210 AUD in 8 days
(1 Review)

Hire me! Please read my PM. Thanks!

$154 AUD in 3 days
(1 Review)

Hi Esuccess ; My name is Alice , I am from , We provide easy to use Websites ,with website builder ,you can own your website for just 20$ and we also have a free SEO with all plans that gives you Goo More

$35 AUD in 3 days
(0 Reviews)

Hi, I have read over your project description and I'm interested in completing your task. I have a 12+ years experience in programming. 8+ experience in PHP. Knowledge in C, C++, PHP, JavaScript and Cold Fusion Knowled More

$220 AUD in 3 days
(0 Reviews)