In Progress

Email Inquiry Form

I need to have an email inquiry form made in html that i will set up on my website.


1. Message title Drop down menu (if its not one of the choices in the drop down menu, the person then inputs the message title into a menu)

2. User enters their email address.

3. How the person found our website, there will be a drop down menu here with choices such as, website they found us on, search engine they found us on etc... But also when they choose an option, there will be a box where they fill in options like what the website name that they found us on, what they searched for on search engines and such.

4. Message body they fill in, with unlimited amount of text that they fill in.

5. Once the user submits, it will save there name & email address to the database or a file on our server (if database you need to tell us how to export this into a document with names and email addresses). Then it will send an email to our designated email address and redirect to a page that we choose.

6. Submit Button

Also i need to be sure that all fields are filled in, so nothing is left blank.

I would also like to have some form of a captcha installed as well. Possibly a very simple number and letter combination or just one or the other.

Basically so robots cant post to it.

Skills: Script Install, Website Design

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

Project ID: #220253