Closed

emailer form

We require a simple php form that has the following fields:

-Name

-Email

-Phone

-Postal Code

-Radio button (house / apartment)

-Moving Date

-# of Bedrooms

-reset/submit buttons

Please see image and text attached for more detailed information.

Skills: PHP, Website Design

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About the Employer:
( 0 reviews )

Project ID: #7719

35 freelancers are bidding on average $41 for this job

siddhartha1

Dear sir, we can do this easily,pls check pmb

$100 USD in 3 days
(47 Reviews)
7.8
viaden

Hi, we're ready to complete your project professionally and in the shortest possible time. Please, contact us to discuss everything and we'll start. Regards, Viaden Inc.

$100 USD in 5 days
(9 Reviews)
6.6
gigapromoters

consider it done...

$40 USD in 1 day
(23 Reviews)
6.5
bobi2004

Hello, we would like to help you with this script. Please check PM for details. Best regards, Bobi

$80 USD in 1 day
(33 Reviews)
6.4
CruzDelSur

hi, contact me if you want see it working on my server. by

$50 USD in 2 days
(32 Reviews)
5.8
crissleo

Hello. We are ready to get this done for you.

$30 USD in 2 days
(10 Reviews)
4.9
avissoft

Hi! I can make for you in 5 minutes. Thanks!

$20 USD in 1 day
(20 Reviews)
4.7
halwasiyainfosys

Dear Sir, We have understood your requirements and can easily do the project as we are having more than 5 years of experience in IT industry and we are India's leading IT company. We offer 100% satisfaction and money More

$20 USD in 2 days
(1 Review)
4.1
CEGRAPHIX

It's pretty simple...can do it quickly. http://www.cegraphix.com for portfolio.

$20 USD in 0 days
(11 Reviews)
4.1
jmdesigns

I already made this for you, please see PMB.

$20 USD in 1 day
(7 Reviews)
4.3
inakiseri

At the end of day i develop around 20 forms of diferents sites, please contact me at

$20 USD in 1 day
(3 Reviews)
4.0
softsolin

Hi, Can be done easily and fastly. Thanks and regards, ashish

$20 USD in 3 days
(8 Reviews)
3.6
kskulkarni

Thanks for considering my bid.

$50 USD in 4 days
(3 Reviews)
3.2
vikrammat

We are keen on taking this up. Visit http://sagaciousindia.com for more details about us

$25 USD in 1 day
(2 Reviews)
3.0
israeliguitar

I can do this for you in one day, less than a few hours from the closing. check the pmb. :)

$40 USD in 1 day
(1 Review)
2.2
Vesna

I would be very happy for the opportunity to work for you. My web design and web programming references can be seen at www.designs.moljac.hr

$80 USD in 2 days
(1 Review)
1.6
pfstearns

I can do this project. I've done similar projects in the past, you won't regreat picking me.

$25 USD in 1 day
(1 Review)
1.6
redyor

it can be done in about 2 hours during today thanks for considering my offer , www.foxwebcreations.com

$20 USD in 0 days
(1 Review)
1.4
Ryanknol

easy as pie

$20 USD in 1 day
(1 Review)
1.4
tanuj99

please see pmb for details

$100 USD in 7 days
(1 Review)
3.3