create jquery form

i want this simple 5 part form, but with some changes : [url removed, login to view]

changes i want :

- part 1 use checkbox instead of radio. Add in another option named "Others"

- part 2 use slider max 10 units [url removed, login to view]


- part 3 is using postal codes from google maps singapore

- part 5 will send confirmation emails to admin & customer. Both emails must contain full booking details.

- yr form must function same like [url removed, login to view] , pls make sure all the validation is kept the same as well.

this should be completable in 2 hours for any expert. MAX payout 30 USD

Last part of form is the date time. Use a jquery datetimepicker

Skills: CSS, HTML, jQuery / Prototype, PHP

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About the Employer:
( 240 reviews ) singapore, Singapore

Project ID: #2579737

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Ready for service

$30 USD in 1 day
(66 Reviews)

6 freelancers are bidding on average $41 for this job


We are 4 years experienced in PHP and [login to view URL] are sincerely read your requirements and ready to endow with the solution as per your [login to view URL] provide me chance to do work on it.I can assure you to provide 100% a More

$30 USD in 1 day
(28 Reviews)

Dear sir, Greetings!!!Certified guys is here according to your requirement. We understand your requirement clearly. Please check your private message for bid details. Thank for your consideration. Regards

$50 USD in 2 days
(5 Reviews)

Please check PMB.

$55 USD in 1 day
(8 Reviews)

Hi, ready to start immediately :)

$30 USD in 1 day
(3 Reviews)

Lets get started........

$50 USD in 1 day
(0 Reviews)

I have 3+ yrs of exp in jquery. I can do it. Thanks

$30 USD in 0 days
(0 Reviews)