Completed

Web Form Dynamic Fields

I need a web form that could output this format below...

Let me know cost and time! PHP and JavaScript if you can

I need separate categories and fields...

It does not need to email.. just pop up a window with the code in the format below....

Incident Management - Resolved

Incident Number

Brief Description

Resolution

Incident Management - Shift Carry Over

Incident Number

Brief Description

Update

Projects

Project Title

Project Update

Preventative Maintenance

PM Title

PM Location

--------------------------------------------------

*<<CURRENT DAY OF WEEK>> Day Shift Report <<CURRENT DATE MM/DD>>*

_Incident Management - Resolved_

`INCXXXXXXX` - Brief Description

• Resolution

`INCXXXXXXX` - Brief Description

• Resolution

`INCXXXXXXX` - Brief Description

• Resolution

`INCXXXXXXX` - Brief Description

• Resolution

`INCXXXXXXX` - Brief Description

• Resolution

_Incident Management - Shift Carry Over_

`INCXXXXXXX` - Brief Description

• Resolution

`INCXXXXXXX` - Brief Description

• Resolution

_Project Progress_

`Project Title` - Brief Description (Pulled from Planner)

• Update

`Project Title` - Brief Description (Pulled from Planner)

• Update

_Preventative Maintenance_

• Maintenance

• Location

Skills: HTML, Javascript, PHP, Website Design

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About the Employer:
( 22 reviews ) southington, United States

Project ID: #18838028

Awarded to:

letsstartcoding

My question is the fileds u described user will fill them and click on submit button and than popu will appear and will show all results to the user, fileds he filled, or need to store the data too somewhere??

$30 USD in 1 day
(8 Reviews)
3.5

6 freelancers are bidding on average $38 for this job

alkajain2906

Greetings,
Thank you for posting a Job. I WILL DO THIS AS PER YOUR REQUIREMENT AND EXPECTATIONS. With the experience of over 300+web development projects including ANDROID, IOS, WEBSITES, WEB APPLICATIONS AND SOFTWARE More

$25 USD in 1 day
(24 Reviews)
5.0
cipvtl

Hi - I have been working for several years in PHP, CakePHP, Laravel, Open-Cart, CI, REST API, DotNet, IONIC, Angular, ReactJs, Vuejs, Android, and IOS etc. I have worked with different types project, for example, OT More

$100 USD in 1 day
(14 Reviews)
4.7
NomanAliKhan89

Hello Here I am with more than 5 years experience in this field. I am working on game development, software development, web development, application development since 2012. I have done many projects on IOS and And More

$25 USD in 1 day
(1 Review)
3.5
scar20181206

Hello dear. My name is Sel, I am a fullstack web developer. I read your text carefully and I want to work on your project. I am an expert of php and php based frameworks. I am good at css html and bootstrap for forn More

$25 USD in 1 day
(7 Reviews)
3.9
navdevsl

Hi There, Greetings of the day!! I have gone through with your project requirement and would like to apply for this job. According to the project description, we can open a pop-up via javascript after form submis More

$25 USD in 1 day
(1 Review)
0.5