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Need custom form for website

I need a custom form designed for my site that will allow a user to enter their name and billing/shipping details along with credit card payment info. I need this info captured and submitted to me in an email each time an order is placed and I will process the payment info offline after verification.

I also need a 'thank you' screen to auto generate that shows the customer their order they just placed.

Expert english speakers only, sorry, no Indian bidders thanks. I prefer US, CA, AUS or UK programmers.

Gary

Kemahiran: Perl, PHP

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Tentang Majikan:
( 21 ulasan ) Millville, United States

ID Projek: #332432

Dianugerahkan kepada:

keithn

Hello, I'll be sending you a PM in just a moment.

$60 USD dalam 4 hari
(34 Ulasan)
5.5

9 pekerja bebas membida secara purata $42 untuk pekerjaan ini

firstdandy

Dear Sir, I'm English Speaker and also not Indian. It's a simple things for me. Have done many complex works before and can work easily on yours. Let's start

$40 USD dalam 0 hari
(129 Ulasan)
7.3
a1dezine

HI, We are ready to finish this job right [url removed, login to view] our website at [url removed, login to view] for more details, Regards,A1dezine Limited

$50 USD dalam 0 hari
(68 Ulasan)
7.0
calavera

Are you serious ? I can make this nice and clean. Input validation for every field, everything you need.

$30 USD dalam 0 hari
(6 Ulasan)
3.9
gafhus

Ready to start

$40 USD dalam 0 hari
(8 Ulasan)
3.5
DamienRoche

Can do this no probs. Check PM. Best Regards, Damien.

$50 USD dalam sehari
(7 Ulasan)
3.4
pledgedmedia

I can do this for you tonight. American Mike T. ([url removed, login to view])

$50 USD dalam sehari
(5 Ulasan)
2.9
meschu

Shouldn't take long. I can start as soon as I get the go-ahead from you.

$30 USD dalam 0 hari
(2 Ulasan)
2.1
thoughtinreality

Hello thanks for review my bid. pl chk pmb for reference. with regards thanks

$30 USD dalam 0 hari
(0 Ulasan)
2.0