I need a custom contact form on a Big Commerce site.
The fields are:
City, State, Zip:
1) My items are clean and in good condition.
2) None of my items are on the do not send list.
3) I acknowledge I will receive payment once my clothes have sold, with the remainder going to my charity of choice.
Pick a box option: 1) Send me a box 2) Request a pick up date (include date)
Choose your charity:
(these will be icons that will be clicked)
1) Leave it to us
1) Charity 1
2) Charity 2
(about 15-20 charities for now with the option to add more in the future)
Once submitted, get a thank you page and an automatic email confirmation. Please refer to the attachment for more clarification.