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Develop Mobile-friendly Form/Widget

I would like for someone to build me an interactive form - similar to this one (link below). It needs to be mobile-friendly - so obviously not Flash-based. I would like it to have similar functionality - submit form, display results in a few tabs, etc. It needs to be easy to tweak (colors and a logo) and easy to install into various websites that I have no control of... however, I do need to somehow get the form submissions copied to my server - or through google analytics.

[url removed, login to view]

Please explain how you would develop this... if you can provide examples of things like that that you have developed, please do.

Payment in full upon completion and validation of project.

Skills: HTML5, jQuery / Prototype, Mobile App Development

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About the Employer:
( 22 reviews ) Carmel, United States

Project ID: #1160244

3 freelancers are bidding on average $711 for this job

sritechnocrat

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globfygroup

Will you prefer Sencha Touch for the app? Please check PM for more details.

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mfranzke

fluid layout for form and form data visualisation page to achieve different dimensions the application will be included into. The form data visualisation page that will get displayed after the form submission will disp More

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