Create Web form for e-mailing multiple recipients

I need a form-to-email type page created that's fairly simple except the user needs to be able to choose from a list of possible recipients which ones should receive the information from the completed form (and any attachments that were included). See the attached description.

I don't know how hard that requirement makes the request, so I'm posting as a simple project. Please bid appropriately in any case. While price is always important, I'll be choosing the bidder based on the specific information they provide about my project and how confident that makes me that they truly understand the project and can complete it successfully.

I need a professional job done, both in the design of the form/page itself (including minor graphics and page design) and the programming behind the form to do the editing and e-mailing.

Skills: Electronic Forms, PHP, Software Architecture, Website Design

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About the Employer:
( 85 reviews ) Las Vegas, United States

Project ID: #1250612

Awarded to:


Got Expertise in doing this sort of stuff... All payments through Milestone Payment (Escrow)... Online 16 Hours a day, Can start right away.. Thanks

$150 USD in 2 days
(632 Reviews)

16 freelancers are bidding on average $178 for this job


View pm for details.

$250 USD in 5 days
(1369 Reviews)

Hi, please check your Private Message Box for more details

$120 USD in 3 days
(158 Reviews)

Hello, I am familiar with email programming. Please see pmb. Thanks, Steve

$250 USD in 5 days
(32 Reviews)

Ready to start!

$179 USD in 3 days
(28 Reviews)

Ready to design requested form. See my message for details.

$200 USD in 2 days
(45 Reviews)

Dear Sir, We are interested in working with you. Over the years we have worked on many projects, both large and small. They have varied in complexity from simple reusable modules to enterprise-wide web-enabled applica More

$229 USD in 5 days
(10 Reviews)

Hello, I'd like to work with you on this project. Please check kindly the private message. Regards, Roman

$350 USD in 5 days
(26 Reviews)

Hi, Experienced developer at your service. Already done this type of stuff with the multiple selection. Please check PMB for more info. Cheers

$175 USD in 5 days
(23 Reviews)

5+ years php/mysql experience - ready to start

$85 USD in 2 days
(4 Reviews)

Hello,Please Check Personal Message

$125 USD in 2 days
(3 Reviews)

Hello greetings I am an experienced web developer with expertise in php & other open source tools. I can build you a professional web based email application. Please check private message for further details.

$150 USD in 2 days
(0 Reviews)

Thanks and have a nice day. I already have the system, please check your PM. The one I PM is required to do some modification by creating a front-page for end user. Other modification may have you UAT on the syst More

$240 USD in 1 day
(0 Reviews)

I have done many such form-to-email web pages. Also have gone through all your clarifications and descriptions. So I am confident of doing the job for you. But , I have some confusions and discussions to have with you More

$70 USD in 3 days
(0 Reviews)

hello, i am here to help you .

$200 USD in 15 days
(2 Reviews)

I am ready to work sir, Dont underestimate me as am new to freelancer

$75 USD in 1 day
(1 Review)