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Simple literature request form

We need a form that people can request literature from our company. The form needs to look like our current site.

The fields in the form are as follows:

- Name (required field)

- Title (optional field)

- Company (required field)

- Email (required field)

- Address line 1 (required field)

- Address line 2 (optional field)

- City (required field)

- State (required field)

- Zip (required field)

Once a user submits their information it will take them to a page thanking them for requesting literature and then after 25 seconds it will redirect them to our site.

The data will be stored in a MySQL database.

You will also need to create a way that we can download the data in Excel format.

Time is of the essence, we need this to be completed immediately.

Payment will only be made once the site is complete and up and running.

Kemahiran: PHP, Reka Bentuk Laman Web

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Tentang Majikan:
( 5 ulasan ) St. Louis, United States

ID Projek: #266194