Single Simple Form to Email and Database

I need a single page HTML CSS responsive form that collects data and saves to a database which admin can login and see. Also emails form data to 2 email addresses.

See form attached. I need this done and finished within 17 hours from now.

Mention HG in comments or your bid will be ignored

I will provide Cpanel access and an account to build the form from, form must be built in provided cpanec access.

Note: I will need a "Add another Item" button so user can add another item to the order form, like item 7, item 8, item 9 etc

Kemahiran: PHP, HTML, CSS, Reka Bentuk Laman Web, MySQL

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Tentang Majikan:
( 379 ulasan ) Newport, Australia

ID Projek: #21805819

Dianugerahkan kepada:


Hello HG, We are up for the task and can complete this in 2 days max! I have checked pdf and background image, It's simple and straight! Let's discuss further on chat and start working on it!

$80 AUD dalam 2 hari
(202 Ulasan)

69 pekerja bebas membida secara purata $132 untuk pekerjaan ini


Hi HG I offer a wide range of services, including , PHP , Website Design , CSS , MySQL , HTML I can create and deliver the project as per the information.I have skilled, expert programmers I'm very excited to ass Lagi

$120 AUD dalam sehari
(537 Ulasan)

I can make a form for you. I have 8+ years of experience in PHP. I assure you that I will give 100% quality work. Let us discuss and proceed further in chat.

$200 AUD dalam 7 hari
(181 Ulasan)

HG I dont do design but if you have the HTML/CSS form then i can do the programming in PHP/MYSQL for this form. I can send the form output to 2 emaill address and also to admin panel. show me the admin panel too. Let Lagi

$100 AUD dalam sehari
(350 Ulasan)

Hi, I have checked the attached pdf file. So on the form , everything will be filled by the user , no prefill filed will be there ? I can make it within your time as per your requirement. I have 10 years of experie Lagi

$140 AUD dalam sehari
(200 Ulasan)

Hello sir. I have good skills and experiences as you requested on your project. You can see my results as follow. https://www.freelancer.com/u/abstractsoftweb?w=f I am very interested in your project. If you hire me Lagi

$100 AUD dalam 2 hari
(155 Ulasan)

HG Hello? How are you? I am excited to work with you on this project. I have good skills in php backend side. So I think I can help you if you want. So i hope to discuss your project vis chat deeply. Thanks. Bes Lagi

$155 AUD dalam 0 hari
(122 Ulasan)

----------------------------------------------------HG--------------------------------------------- Hello, I am highly interested to work with this project. I can complete it within the next 5 hours. I am a profession Lagi

$150 AUD dalam sehari
(127 Ulasan)

Hey HG I have read your proposal and I have read that you need that in 17 hours. I have understood your requirements and I am sure I can deliver the work in 17 hours. The background image should be used as background?

$70 AUD dalam sehari
(157 Ulasan)

HG I have good knowledge of PHP, Ajax, Jquery and MYSQL. I able to do this task very well with good quality. Our main motto is client satisfaction and makes a long-term relationship with you. Thank you

$175 AUD dalam 2 hari
(134 Ulasan)

Hello, Greetings of the day! I've gone through your posted job description. Could you please share the task list and specs of this project so that I can analyze them and can share my understanding over it, On that bas Lagi

$150 AUD dalam 3 hari
(219 Ulasan)

"HG" - Hi, I can complete it on time ( < 17 hours ) with best quality of work. Please hire me. Thank you !

$170 AUD dalam sehari
(612 Ulasan)

HI, I like to help you out for PHP tasks. I do have experience in PHP and its framework CodeIgniter. I am full time freelancer i also know HTML, CSS, JS, Ajax, Jquery, etc. most of time i do all the work in website fro Lagi

$100 AUD dalam 2 hari
(88 Ulasan)

hello sir i am expert in php and html/css i am able to do this work you will satisfy with my work i can do this work asap thank you

$140 AUD dalam sehari
(200 Ulasan)

HG Hi there, I checked pdf, i will design and build same form like you want. I have 7 years experience in WordPress. Feel free to contact me. I can start work on this project right now.

$100 AUD dalam sehari
(219 Ulasan)

HG Hi I checked the requirements and i can create the form with in few hours . Can we have a discussion ? i am ready to start the work right now . Thanks

$200 AUD dalam 7 hari
(61 Ulasan)

"HG" Hi, there. i can do this project within 17 hours from now. Thanks for your contact me. i have read your description and very interested in your project. As you can see at my profile, i am a expert web development Lagi

$160 AUD dalam sehari
(59 Ulasan)

Hello, Greetings!! I have checked both the attachments. So the user can add any number of items from the form?? Is the site is already built where I need to add this form? I will love to assist you with this task Lagi

$250 AUD dalam sehari
(138 Ulasan)

Hi, I am 8 years experienced web developer . I understand your point. I can complete this project within two days. Please check my profile for my work quality . Thanks, Bhaskar Mandal

$80 AUD dalam 2 hari
(105 Ulasan)

"HG" Hello Thanking you for posting the project. I am having more than 5 year in Designing and Development. Please provide me all the details so i can through and start the work And expertise in Creating Responsi Lagi

$100 AUD dalam 2 hari
(108 Ulasan)

HG Hi Sir/Madam, Thank you for going through my proposal for your Job titled I have gone through your job posting. I am an Expert PHP Developer with extensive experience of developing web and mobile applications. i am Lagi

$100 AUD dalam 7 hari
(112 Ulasan)