You should only do the front-end work. No back-end work is necessary from your part.
NB! This is not a complete site not even a complete page you should only create a small part of a page.
17 freelancers are bidding on average $133 for this job
Hi I read your job very carefully. I have rich experience about (Cake Php, Codeigniter, Laravel, Nodejs, Html, Html5, Css, Css3, Jquery, Bootstrap,Mysql) for 9 years. Stay tuned, I'm still working on this proposal.
Do you want Ajax get/post setup on the front end and linking to a php script? I can return the fakes into the fields for you using custom jquery (no external plugin)