Form on Web Page to capture customer data

web developer that can create a form, which will capture clients data and fire an email according to rules created in a database The form will have a few fields that are shown based on rules created in a database. I need a backend page to view, add, edit entries in the database, the Full specification is in the attached document...PLEASE NOTE the document is in Portugues AND ENGLISH (in RED)

DO NOT MAKE ANY OFFERS IF YOU CANNOT TAKE ON THIS JOB WITHIN THE AGREED TIME. Please also read the full doc before making an offer Thanks

Skills: HTML, Javascript, MySQL, PHP, Website Design

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About the Employer:
( 2 reviews ) Santos, Brazil

Project ID: #16180369

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$25 USD in 1 day
(12 Reviews)

4 freelancers are bidding on average $25 for this job

$25 USD in 1 day
(42 Reviews)

Hi, I am Word press Expert. All kind creates a website. I have good experience in website design & development. Please initiate chat to discuss further.

$25 USD in 1 day
(46 Reviews)

Greetings, It’s our gladness to associate with you on this project. I am a web developer with 6+ years of experience in plenty of verticals. Relevant Skills and Experience Some of my skills are mentioned below: HTM More

$23 USD in 1 day
(25 Reviews)