Convert 2 pdf forms into 2 webpage fillable forms with database and email capture

进行中 已发布的 Apr 9, 2014 货到付款
进行中 货到付款

I have two forms that people submit to me regularly. They are both currently in pdf and are either completed on desktops-saved-and sent back to me filled in, or faxed bak after hand filling in. I want each form available on my website as a fillable form with for submission directly to a database record.

Form #1: regional_subform

20 fillable fields, all text (Currently 19 fields but adding one fillable URL field).

The form must also ask for a submission key code, which is unique, generated by us, and provided only to authorized parties.

Form #2: regional_blanket

This is basically a contract with 11 fields that need to be filled in (day of month, month, year, dba name, company name, company address, company phone, officer name, officer title, officer signature, email address).

The date fields should populate with the current date that the form is being completed, all other fields are to be filled in by the user.

There should be a required checkbox (unchecked by default) and statement that indicates that the person submitting the form is authorized to act on behalf of the individual/business/entity named, and that they have read and understand the terms of the agreement.

A statement should also appear next to the submit button that the form will be reviewed within 1 business day and if approved a confirmation will be forwarded to the designated email address, or if there are questions we will follow up via email or telephone.

Both forms should have some type of anti-bot protection like captcha.

Both forms should confirm to the user after submission that their data has been sent, with a link to back to the mail site submission page.

Please see attached pdf form file sample of form #1.

电子表格 HTML MySQL PHP

项目ID: #5784581

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5个方案 远程项目 活跃的Apr 9, 2014