Completed

Create an online application for customers

I am looking for a developer that can create an online application with a certain set of questions for potential customers to apply for program membership applicable to the product we offer. The application should do the following things:

-Be able to determine if an applicant is eligible for the program based on the answers to certain questions.

-Store the application in a database/Excel file/etc. once a customer clicks on "Submit" (I am looking for a recommendation of the programmer as to the best way to direct and store this information so that it is accessible by our administrator).

-If the applicant is eligible, the "Submit" button should send the applicant to a new page where they can enter payment information.

-If the applicant is ineligible, they should be directed to another page (creation of this page and payment page are NOT part of this project).

I am looking for a form that can be incorporated with the theme of an existing website if possible. The application should include a combination of text boxes, check boxes, drop-down menus, etc. that would best represent the PDF version of the application (file attached).

Skills: ActionScript, HTML, Java

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About the Employer:
( 3 reviews ) Boston, United States

Project ID: #696995

Awarded to:

vios

PHP/MySQL professional is here. Please check PMB.

$250 USD in 3 days
(8 Reviews)
4.5

18 freelancers are bidding on average $304 for this job

lightcresent

Expert in doing this sort of stuff... No upfront needed, all payments through GAF Milestone Payment (Escrow).. Online 16 Hours a day, Can start right away.. Thanks

$300 USD in 8 days
(165 Reviews)
8.3
dewmagic

Please see PMB for oour works

$250 USD in 3 days
(99 Reviews)
7.1
siddhu1986

Hi, kindly check PMB. Thanks.

$300 USD in 8 days
(109 Reviews)
6.3
AStonetech

Please check PMB for more detail. Thanks

$250 USD in 3 days
(67 Reviews)
6.1
pixarsolution

We can do this job for you. Check PM

$300 USD in 8 days
(22 Reviews)
6.0
outsourcing

Please check PMB

$250 USD in 5 days
(9 Reviews)
3.8
CharlieSchwa

Hi, I think the best way to store the data would be in a mySQL database, which will be faster than writing the data directly to a file. You would be able to easily export the data into another format like text or exc More

$250 USD in 2 days
(3 Reviews)
3.6
eagle2k13

Please see the PMB. I look forward to working with you!

$250 USD in 5 days
(3 Reviews)
2.8
FaridJC

PHP/HTML/JAVASCRIPT Expert. Experienced on reports in Excel and PDF.

$250 USD in 10 days
(0 Reviews)
0.0
kayostudio

hi,i want to do it, give me a chance, i will redouble our efforts. i can show some sample for you. look forward to your reply.

$400 USD in 5 days
(0 Reviews)
0.0
haeloong

hi, i can do this for you at your preffered programming language (asp/php/jsp) to ease integration to your website. i have rich experience in web application development for 6 years. thanks.

$500 USD in 4 days
(0 Reviews)
0.0
nitingoswami111

This is my understanding of your requirement. [login to view URL] will be able to enter the type of Quiz Question like Text Box Answers, Single Selection from a Drop Down list , Multiple Selection from a drop down list , Radio bu More

$275 USD in 7 days
(0 Reviews)
0.0
omxteam

please check pmb

$450 USD in 15 days
(0 Reviews)
0.0
albariconsulting

please check PMB for details

$500 USD in 7 days
(0 Reviews)
0.0
rajivkumarpathak

We are a professional group of ASP/PHP/MySQL/HTML/CSS/MSSQL/VB6 professionals and would be intrested in this project we you could share with us the template of the website we could move forward

$250 USD in 10 days
(0 Reviews)
0.0
priya30nov

I can do this project with very good design.

$300 USD in 8 days
(0 Reviews)
0.0
titan2201

I will implement fastest and cheapest

$250 USD in 7 days
(0 Reviews)
0.0
mehmoodahmed

i can do. Kindly send me some more detail about your work.

$400 USD in 30 days
(0 Reviews)
0.0