Need a php form or htlm for created fast :)

We have a Hidden Form system that we use that we cannot allow our customers to access.

So we need to create a mirror form for our customers to fill out, then we will take what

they fill out, and manually fill out the hidden form.

Here is the video to show you what we need: [url removed, login to view]

This is an easy job, but if your really good with software desgin and development,

we may be interested in hiring you to recreate the entire system :)

For now though, it's just a simple form to create that we can put on our server to use.

We need it done today if you have time.

Skills: Electronic Forms, HTML, PHP, Script Install, Website Design

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About the Employer:
( 16 reviews ) Jupiter, United States

Project ID: #1137022

Awarded to:


Lets do this! See PMB

$40 USD in 1 day
(112 Reviews)

10 freelancers are bidding on average $90 for this job


Please take a look at PMB. Regards

$80 USD in 1 day
(105 Reviews)

Dear sir, Thank you for give me a chance to bid on this project. I can complete your job within 0 day and properly Please check my PM.

$30 USD in 0 days
(42 Reviews)

Hi, We have go through the Project requirement and ready to do this project for you. Please check your PMB

$210 USD in 4 days
(7 Reviews)

easy for me. let's start.

$35 USD in 0 days
(40 Reviews)

Please check pmb

$150 USD in 7 days
(1 Review)

Hey there! If this is what I think it is, I can have this done within the hour.. basically, you're just wanting to replicate that form in the video, and have the results emailed to yourself when a user submits the f More

$40 USD in 1 day
(1 Review)

I can offer the best service for this task and am able to deliver my service within 2(two) days. I am very much interested to discuss with u about the project criteria and requirement by online conversation

$75 USD in 2 days
(0 Reviews)

We can provide u a good project as you like

$150 USD in 4 days
(0 Reviews)

please check pm

$40 USD in 0 days
(0 Reviews)

check your PMB.....

$75 USD in 0 days
(0 Reviews)