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Order Forms

I need two order forms integrated with paypal.

1st form:

Text Field: First Name

Text Field: Last Name

Text Field: Phone

Text Field: Email

Text Field: Address

Text Field: Postal Code

Text Field: State

Text Field: Country

Drop Down: Beginner Plan [url removed, login to view], Business Plan [url removed, login to view], Premier Plan [url removed, login to view]

Text Field: Cpanel/ftp Username

Text Field: Password

Drop Down: Regester New Domain [url removed, login to view], Use Existing Domain (I Will Update My Nameservers)

Text Field: Domain

Text Area: Additional Information

This form will need to calculate both what the person puts in for their package and if they choose to regester a new domain also add in [url removed, login to view] For example: If a customer chooses the beginner plan and a domain the paypal screen once they click submit will have to create a subscription per month for 2.99 as well as a subscription per year at 12.99.

You can take out all the stuff underneith the flash in that open space and make a neat and clean looking form that uses grey/silver or navy blue.

Form submits to [url removed, login to view] at [url removed, login to view] and redirects to a page that says Thank You for your order! It is being processed now. Please allow up to 24 hours for you to recieve your account information via email and up to 72 hours for your domain.

---------------------------------

Second form:

Text Field: First Name

Text Field: Last Name

Text Field: Phone

Text Field: Email

Text Field: Address

Text Field: Postal Code

Text Field: State

Text Field: Country

Drop Down: Bronze Plan [url removed, login to view], Silver Plan [url removed, login to view], Gold Plan [url removed, login to view], Premier Plan [url removed, login to view]

Text Field: WHM Username

Text Field: Password

Drop Down: Regester New Domain [url removed, login to view], Use Existing Domain (I Will Update My Nameservers)

Text Field: Domain

Text Area: Additional Information

This form will need to calculate both what the person puts in for their package and if they choose to regester a new domain also add in [url removed, login to view] For example: If a customer chooses the bronze plan and a domain the paypal screen once they click submit will have to create a subscription per month for 19.99 as well as a subscription per year at 12.99.

You can take out all the stuff underneith the flash in that open space and make a neat and clean looking form that uses grey/silver or navy blue.

Form submits to [url removed, login to view] at [url removed, login to view] and redirects to a page that says Thank You for your order! It is being processed now. Please allow up to 24 hours for you to recieve your account information via email and up to 72 hours for your domain.

Form 1 should be: [url removed, login to view]

Form 2 should be: [url removed, login to view]

My paypal address is [url removed, login to view] at [url removed, login to view]

Please tell me how long this will take and if you need more than 20$ Thanks!!

Habilidades: PHP, Instalação de Script

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Acerca do Empregador:
( 13 comentários ) West Friendship, United States

ID do Projeto: #23149

20 freelancers estão ofertando em média $50 para este trabalho

infoway

Ready to start now. view PMB.

$50 USD in 2 dias
(83 Comentários)
7.9
AtlanticSoft

Please Check PMB

$30 USD em 1 dia
(174 Comentários)
7.8
Properbouncetech

Hello, thanks for your bid invitation and think our price and time span are the best one as per your budget and project. Pls. See PMB. Regards.... Microsectec.

$55 USD in 5 dias
(38 Comentários)
7.0
cstl

[url removed, login to view] is a customer-specific service oriented company has got an Professional and creative team with 6 years experience in Web design , web programming and software development . We have expertise and e Mais

$80 USD in 7 dias
(20 Comentários)
6.9
jobonline

let me do it for you again!

$30 USD in 0 dias
(56 Comentários)
6.5
expprog

hi, can i get a chance. Pls see PMB. Regards

$80 USD em 1 dia
(43 Comentários)
5.9
bornalex

Can be done ASAP.

$30 USD in 2 dias
(54 Comentários)
5.9
infogatesoftware

InfogateSoftware is the only ISO 9001 certified company listed here. We are in the field since 1998. We have a large and highly experienced team of Programmers, designers, technical writers and others to do your work i Mais

$30 USD em 1 dia
(10 Comentários)
5.4
remtools

I'v got exprience and am I'm Ready to start..

$30 USD em 1 dia
(5 Comentários)
3.8
softevision

Dear Client ==== Thanks you for opportunity to bid on your project ==== We have already experience of working on related [url removed, login to view] check PM for more details ==== Thanks and Best Regards, SofteVision

$50 USD em 1 dia
(3 Comentários)
3.4
tanuj99

pl see pmb for details

$100 USD in 7 dias
(1 Comentário)
3.2
kalesh777

can be done easily for if you have questions send me a pm

$40 USD in 2 dias
(1 Comentário)
1.0
arpanet

Dear sir. Thank you for giving us an opportunity to bid on your project. We can start immediately. we have been working on web development since 6 years. We conduct software development online of Elance ,where w Mais

$40 USD em 1 dia
(0 Comentários)
0.0
Randeep

We are a group of highly educated professionals with specialization in various fields. although we are new to [url removed, login to view], we have done such projects before and we are confident of doing your project. We will always be Mais

$30 USD in 5 dias
(0 Comentários)
2.4
virtualtech34

can be done ... XXXXXXXXXXXXXXXXXXX

$40 USD em 1 dia
(0 Comentários)
0.0
a6sridhar

Please visit [url removed, login to view], a sample site for you to see. It is developed for a client in USA. We can provide you chat services at a very nominal cost. If operator is not available few customers may not be re Mais

$81 USD in 3 dias
(0 Comentários)
1.0
smritiksinha

I have the experience of designing such form earlier using PHP and Perl

$50 USD in 10 dias
(0 Comentários)
0.0
ninadbe

Hello Sir, We can do it in given time. We have more than 2 years of experience in Website developement in PHP. Plz contact me if u r interested. Thanking you. Mais

$100 USD in 5 dias
(1 Comentário)
0.0
manjeetsingh

Hi, I have five years experience, i have done many such projects. integration with paypal, [url removed, login to view], epdq. contact me for further details thanks with regards, Manjeet

$30 USD in 0 dias
(0 Comentários)
0.0
contractworker

How about trying something that's New, Innovative and without compromising on the quality! Allow us to show our potential. Regards, Marketing Dept. SmartBraiz

$32 USD in 2 dias
(0 Comentários)
0.0