Simple Form (PHP + MySQL + JavaScript)

We need someone to help us create a simple web form that we'll be embedding into our website. We unfortunately need this project ASAP (< 3-4 hours).

The form needs to be be kept as simple as possible:

1) Four fields (Name, E-mail, Phone Number, ID) [all required, except for the ID variable which we will want to have as an input type=hidden and define the value ourselves. The end-user will only have to input the Name, E-mail and Phone Number values.

2) We'd like some AJAX functionality so that the page isn't redirected anywhere but a small success message appears and the user can stay on the same page after submitting their data.

3) All the data must go into a MySQL database, and we'd like an additional page that shows all the data. Nothing fancy, just a html page with a table and all the values in their respective columns.

3a-optional)It'd be nice to have an export into Excel/CSV file feature on this page, but it's not a priority.

4) We'd also like to utilise a cookie so that users won't have to enter their details within the form too many times. It's up to you how you do this, but it's a necessity.

The main/key consideration here is that this same form will be embedded into a website multiple times (on the same .php page), and so you must be confident that it will work. That being said, our CMS can append or pre-pend a specific number to the fields, to keep things from getting duplicated.

You don't need to worry about styling - we can handle that part.

The main consideration is that this form will be duplicated at least 4 times on the same page - but we can assign a numerical value to all the fields (to keep them separate).

The winning bidder will be paid via GaF's escrow service, and will be chosen based on price and delivery time considerations.

I forgot to mention:

We're basically offering a service at a conference for users to be reminded of specific events. One page has all the listings, and each listing will have this form next to it; hence why it is being displayed so many times. It is very likely that after the user has submitted their details for one event, they will browse further below on the same page and will want to be reminded of another event, which is why the ajax and cookie functionality would be very handy. Let me know what you think - I'm willing to cut back on the Ajax stuff but the cookie functionality is essential.

Thanks again!

Goodness - I forgot a couple more things:

1) There is a 40% bonus on your bid if you can successfully finish the project within 6 hours.

2) We'd also like to track the IP address of the user submitting data, and have it available in the database.

Habilidades: Processamento de dados, Javascript, PHP

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Acerca do Empregador:
( 5 comentários ) London, United Kingdom

ID do Projeto: #175944

Concedido a:


let's do it right now. :)

$50 USD em 1 dia
(96 Comentários)