HTML Form, linked to an SQL - for datacapture

Need an HTML form, with text boxes and several check boxes - that match document attached - that is linked to an SQL table. I have an attached the a pdf, detailing the names and formats for the fields.

the form customers will fill out is slightly different depending type of property;

I would need the customer to be able to choose "Detached, Condo, Townhouse, etc" and the form for them pop up. I will provided changes for 2 different property types to bid winner. I will send winner my web address so you can see where the form is needed.

i use BLUEHOST to hostg my site, I have 5.0.89-community-

log mySQL, [url removed, login to view] php; My CPANEL webserver has SQL table functionality - which I can give you access details to, for uploading.

I would need help loading on my server.

With my basic knowledge of html, I need to be able to amend the fields / layout myself - and re-loaded the revised form myself, subsequently. Ideally with code to min spammers. Please write that you "Have Read and Understand reviewed pdf."

simple, quick job, for the right person.

Skills: Electronic Forms, Format & Layout, PHP, SQL, Website Design

See more: sql code pdf, simple pop server, pop layout, need sql help, linked on, linked n, linked i, job for write, html web design pdf, html 5 up, html 5 table, html 5 pdf, html 5 basic code, basic website html code, sql server job, simple html code for website design, layout html 5, townhouse, sql, Sql code, SQL Access, re-type pdf, linked, html help, html changes

About the Employer:
( 3 reviews ) ATLANTA, United States

Project ID: #588307

Awarded to:


Have Read and Understand reviewed pdf. I also have a solution for avoiding spamming. I'll also implement full validation for the entered data by users. Please check the PM for my details.

$100 USD in 4 days
(15 Reviews)

20 freelancers are bidding on average $125 for this job


Have Read and Understand reviewed pdf. Dear sir, I am excited to start immediately and looking forward for your selection. Let me know more details. I can assure you quality design and coding.I am always availab More

$120 USD in 3 days
(95 Reviews)

Have Read and Understand reviewed pdf. Hello Sir, Form expert here. Also, I've experience working in bluehost. Please take a look at PMB

$149 USD in 3 days
(95 Reviews)

Hello. Please, check PMB

$120 USD in 3 days
(24 Reviews)

you have PM

$150 USD in 2 days
(10 Reviews)

Hi, please check PM for details. Thanks

$155 USD in 5 days
(44 Reviews)

Kindly check your PMB

$100 USD in 5 days
(7 Reviews)

Hello. Let's start. Thanks.

$100 USD in 0 days
(15 Reviews)

Have Read and Understand reviewed pdf. Hi, I am interested on this project. I have been working with php/mysql/js (jquery)/ ajax for more than 4 years for different enterprises, so I am sure I can do it right. If any q More

$110 USD in 5 days
(9 Reviews)

this is very simple job. i can complete this task with in few [login to view URL] can believe on me.

$71 USD in 0 days
(2 Reviews)

We have 5 years of extensive experience in web programming, web designing, web2applications, Rich web based application. We worked on all major CMS, Custom Script Installation, Shopping cart portals and interactive lea More

$120 USD in 3 days
(0 Reviews)

Hi, I am working as a php website team leader and having 1.4 years of experience. I am sure for my outputs and maintain professionalism at work. Hope i will have contact with you soon and will have great pleasure to w More

$120 USD in 9 days
(0 Reviews)

I am an expert on HTML, PHP, and MySQL. I can do this job quickly and efficiently to your exact specifications. ( I Have Read and Understand reviewed pdf )

$100 USD in 2 days
(0 Reviews)

I can work on this if the price will be as i set it .

$400 USD in 3 days
(0 Reviews)

Hello, I have gone through your complete requirement and PDF document. Let me know if you have database design for this, if not I will design it for you. Can start ASAP. Regards.

$100 USD in 5 days
(0 Reviews)

Hello Mine name is Nikola, I am a 23 year old student ( 3rd year Software engineering) from Serbia. I looked and analyzed your project, and I believe i can do it to your specifications and that you will be please More

$100 USD in 5 days
(0 Reviews)

Plz Check the PMB ..!!!

$100 USD in 3 days
(1 Review)

Have Read and Understand reviewed pdf. Hi, Please check PMB for further details. Regards, Sumit

$100 USD in 3 days
(0 Reviews)

I have understood your requirement and analyzed the pdf attached. Would be great to do business with you. Thanks.

$150 USD in 3 days
(0 Reviews)

Just gimi a shout with the info and i can get it done!

$30 USD in 20 days
(0 Reviews)