SImple form to fill up a mysql database

Small job:

Online form:

This is just a name/address form for a competition, it is not high security, but we are using SSL on the form for safety. The data is not secret. It is about 30 fields, text fields, one email field.

More details:

I have created a Mysql database (with cpanel)

No fields yet.

Data entry from an online form (on Geotrust Quick SSL).

This will be a php - or maybe not, I suppose an html form might suffice.

I need a simple mysql db with name, address, tel. etc. Total about 30 fields, all free text with 2 checkboxes for the applicant and an email field with verification on it.

Thie form creates records on the database.

Then an administrator (one or two only) can login and see the records of names/addresses etc.



The db also creates a random number (or pseudo random) that can be used as the person's username, and a password.

This is not for logging into the MySQL db, it is for access to a protected directory (not part of the job) with extra information (again not secret, just not public).

This is sent to the applicant with the receipt email.

The username has to be anonymous, not their name, this can be generated (some mix up of db record number so it is not just 'username-01' '-02' etc. It will be like 'rrc-random-number' so that the order number (1,2,3...) is not shown.



Ms X fills up an online form (on SSL), basic info, name, address, etc.

They get a receipt email back confirming details arrived, with a username that is a random code (ie not their name), and a random password.

This username/pw they will use later for logging into the protected area on the website.


Admin staff will have a form to inspect/edit the MySQL fields.

There will also be 3 fields on the database that admin staff can alter, check boxes on the admin form, for 'paid' and 'credentials received' and 'credentials approved', also a Notes field.

That's all that is needed.


I have cpanel and have created the database; then I am too new to it & busy to code the forms, database etc.

I have the system set up, the domain/server is only for this job and it is not live yet so is a nice easy working environment. Or ypu can work on your own system and install later.

How much is this and how long will it take?

I am working in ringgit (Malaysia) so all is low budget compared to UK job.


Skills: MySQL

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About the Employer:
( 31 reviews ) London, United Kingdom

Project ID: #694550

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Your requirements are indeed simple. I will have it ready for you in no time.

$50 USD in 3 days
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23 freelancers are bidding on average $100 for this job


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$35 USD in 4 days
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i can do this.

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Ready to start. check pmb for our portfolio.Thanks..

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Please refer PMB in the inbox.Thanks.

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Hello from Philippines your neighboring country. I can do this project for 30 bucks and will be delivered within a week or less.

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YashpalSingh123 Professional, ready to start

$200 USD in 2 days
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I can do this for you sir

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lets start!! Check reviews - In the UK and ready to start

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Hello Please check PMB

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Sir please check PMB for details.

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will take the job. would keep upto date through emails & skype

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i can do it

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Hi..I can do your stuff. Please check PMB.

$100 USD in 7 days
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Hi this is a serious project and i want to help you. i can do it and improve it later if you want.

$60 USD in 5 days
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Hi, I am based in the UK and will complete this job professionally and within budget. Check out this similar job I completed for another client - [url removed, login to view] . I am on sk More

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sir its my wish i will work on your project kindly give me a chance. Thank You

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