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Single Page Form for an already existing website.

I have a website already working. I need to add a form like the one attached that can be filled out by the person viewing the website. Fields are limited to the amount of characters. When the person filling out the form completes the form, there should be a send button. When he presses SEND...it sends him a copy of what he just filled out and also send an editable file with the name of the file being "the zip code he filled out"+"the first four characters of his email address" to a specific email address that I will give to the person awarded this job. Also, there are three fields. Open Mic, PTT and RX Only to the right of the User. These should be radio buttons. Only 1 of those can be checked per users. Also, there can only be a maximum of 12 "Open Mic" So, if the user tried to make a 13th Open Mic, a message box would pop up alerting him that he has reached his limit of 12.

技能: HTML, Javascript, PHP, 网站设计, WordPress

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关于此雇主:
( 3个评论 ) LOWER BURRELL, United States

项目ID: #17002682

24 威客就此工作平均出价 $27

vyasrohan

Hello There, How are you? I hope you are having great time in your life. I am having more than five years of experience in wordpress. I have seen the form you had attached and I can make it. I will apply al 更多

$25USD 在1天里
(219条评论)
7.8
AdroitTechnoSoft

We are committed, honest, and reliable, and We try our best to provide customized designs and quick responses. We will provide you daily update.--- You can check out our recent project [login to view URL] - 更多

$15USD 在1天里
(151条评论)
6.9
webjinn

HI there I have gone through your project details, i can do that job easily. I have developed many skills so far. In languages and open sourse softwares. Front-end :javascript ,jquery,bootstrap,sass,compass,node.js 更多

$35 USD 在3天内
(120条评论)
5.8
ssmlrehan0

Hello, Greetings from Rehan Arshad :) I will definitely add Single Page Form to an already existing website as per your requirements. I am expert in Developing and Designing for a website with great experience 更多

$35USD 在1天里
(51条评论)
5.5
rvtechsolution

Hello I'm quite known for completing websites under a given deadline and that too with maximum quality!! I am interested and ready to create Single Page Form for an already existing website. Here is my WordPr 更多

$40USD 在1天里
(40条评论)
5.1
shahidabro8

Hello! Nice to meet you. I have read your project carefully and what I want is, I will complete it more professionally. I have rich experience with web development! Have more than 5 years experience with Front-en 更多

$25USD 在1天里
(28条评论)
3.5
DarkHunk

Hello Sir, I have read your job very carefully and analyzed all the details. I request you to please go through my Portfolio. It will give you the brief idea of my work. My selected previous work as follows: 更多

$25 USD 在2天内
(6条评论)
3.4
VisionXTech

Hi, How are you? I have good knowledge of PSD to HTML, Mobile Jquery, WordPress, Codeigniter, php,Ajax,HTML5,CSS3, mysql, PDO SQl, Bootstrap, All Browser and Mobile Responsive Design. Recent Work: https://ser 更多

$25USD 在1天里
(1条评论)
2.6
anoirwork

A proposal has not yet been provided

$55 USD 在3天内
(8条评论)
2.4
$10USD 在1天里
(5条评论)
2.0
$25USD 在1天里
(3条评论)
2.1
pkbonly

Hello, I am very much interested on your project.I feel that I am the exact match for your requirements after thoroughly reviewing the job description and desired skills. Thanks

$25USD 在1天里
(1条评论)
0.8
adarshp199877

Hello ! I am working on several websites. I can create a ecommerce or personal or professional website at lowest cost. you can hire me to add payment gateway,SSL certificate, SEO etc. to see my works visit my profile. 更多

$25USD 在1天里
(1条评论)
0.7
raaf003

A proposal has not yet been provided

$25 USD 在7天内
(0条评论)
0.0
ossamafareed7

A proposal has not yet been provided

$30 USD 在2天内
(0条评论)
0.0
bustaf

A proposal has not yet been provided

$25 USD 在5天内
(0条评论)
0.0
dylankotze

Hi there, I have lots of experience in web development and WordPress development and would really like to help you with this. Please let me know if you are interested.

$25 USD 在4天内
(0条评论)
0.0
suvojitrajkar

I am A full stack developer with plenty of experience in this field. Worked on similar projects before. I am confident about this project.

$25USD 在1天里
(0条评论)
0.0
UmairAttiq92

Hi I am Umair .I have Experience about these type of [login to view URL] i am available for new [login to view URL] please send me details of Work With Website URL .

$10USD 在1天里
(0条评论)
0.0
ProjectManagerCS

Hi my name is Christopher, I am a 1099 employed project manager. I have managed projects worth over thousands of dollars. Please message me the details and we can begin asap.

$25USD 在1天里
(0条评论)
0.0