PHP Contact Form - Reposted

Projek ini dianugerahkan kepada firstdandy untuk $50 USD.

Dapatkan sebut harga percuma untuk projek seperti ini
Bajet Projek
$30 - $250 USD
Jumlah Bida
Penerangan Projek

This has been reposted as the winning bidder is now refusing to do the work. Please only bid if you are serious!

We are looking to enhance the current contact form that can be viewed at: [url removed, login to view]

The form is HTML and the script should be PHP.

We want the contact form to have the following fields:

These ones are mandatory fields and there needs to be validation to ensure that they have been populated

Your full name

E-mail address

Your telephone

Company name

These fields are check boxes and are option fields but at least one of them must be selected. The default value is for them to be blank:

PerTOOLS Financial Analysis for Excel

PerTOOLS Data Extractor for Excel

The following field will be a list (we already have the values that need to be in the list and can provide them):


When the user selects the submit button there should be validation to ensure the form has been correctly completed. If the form has not been correctly completed show the user an error message explain what they need to change. If it has been correctly completed the following page should be displayed [url removed, login to view] The data that has been collected needs to be emailed to two different addresses.

The first email is to our email address and every time the form is submitted this address should receive a copy of the details.

The second email address will depend on which country the user has selected (e.g. if a user selects USA the details go to one email address, if they select the UK the email goes to another address). We need to be able to send request for each country to a different email address.

An email should be sent to the Client with the following details:


Subject: Free Trial Request


Thank you for your Free Trial Request. Your request has been passed to your local distributor who will contact you shortly.

If you have not received your free trial within 24 hours, please contact

Many Thanks

The PerTOOLS Team

For the look and feel of the form, please look at the current one at: [url removed, login to view]

Feel free to ask any questions. We are looking to get this done as soon as possible.

Dianugerahkan kepada:
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