Email script needed

I would like my customers to fill in a form with potential customers

Field 1 : Name Current Customer

Field 2 : Email Address Current Customer

Field 3 : Name Potential customer 1

Field 4 : Email Potential customer 1

Field 5 : Name Potential customer 2

Field 6 : Email Potential customer 2

Field 7 : Name Potential customer 3

Field 8 : Email Potential customer 3

Button : Send


after email is send the following tekst needs to be send to all 3 potential customers [Field 1 + 2 + 3] needs to filled in to be able to send.

from : email needs to be send from [Field 2]

subject : test subject text


Hallo [put name of FIELD 3/5/7],

test texst.

text link 1 (needs to link to [url removed, login to view])

aanmelden (needs to be link to [url removed, login to view])

Met Vriendelijke Groet,

[name of FIELD 1]

**** the text I will change afterwards. An email with the names and emails of sender and potential customers needs to be send to info (at) [url removed, login to view], please let me know if you can make this script for me. website links and email i will change afterward

design : Modern White and grey feel

Skills: Graphic Design, HTML, PHP, Website Design

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About the Employer:
( 4 reviews ) Den Haag, Netherlands

Project ID: #1244506

Awarded to:


I can create this email script in PHP and finish it with in 1 day. Thanks, Suresh

$35 USD in 1 day
(774 Reviews)

7 freelancers are bidding on average $69 for this job


lets do it now...........thanks

$35 USD in 1 day
(126 Reviews)

Hello. I can create such mailing page for you fast and quality. Best regards, Andrew.

$100 USD in 2 days
(10 Reviews)

I can do this in less than a day. Please check your inbox for the details.

$30 USD in 0 days
(5 Reviews)

Hi! I can do it.

$180 USD in 1 day
(0 Reviews)

hi, we understood your [login to view URL] check pm for more detail. thanks, jakit.

$30 USD in 0 days
(0 Reviews)

Hi, Please check PM. Thanks

$70 USD in 3 days
(0 Reviews)