Em Andamento

Contact Form with Captcha

See attached pre-made form. I'd like you to make it work =)

The person filling out the form should be required to enter captcha data that is verified before the form is sent. Name, email & phone must be required pieces of information. If the person does not enter the captcha data or enters it incorrectly OR if they do not enter their name, email & phone, an error message should be displayed. I'd like it be easy for me to change the error messages. I would like three error messages: one for incorrect captcha, one for missing captcha and one for missing name, email or phone.

Once the captcha data has verified and the name, email & phone have all been confirmed present, the information from the form should email to an address I'm able to specify in the code.

The email sent to the specified email address should be formatted in an easy to read format such as . . .

I am interested in the following services:

Breast Augmentation, Lift, Reduction

Laser Hair Removal

General Consultation

I heard about you from: a Referral

Name: Their Name

Email: Their email address

Phone: Their Tel #

I hope that's enough example :)

See attached form as your guideline for the email. The exact form attached should be used as the display HTML. Also, I would prefer that the page refresh the least amount of times as possible. So, the person submits the form, the page refreshes to the "Thank you" text. And that's it. Please no external mail send file. I'd like it to be all contained at the top of the file unless you can tell me a really good reason of why not to do it that way =)

Habilidades: PHP

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Acerca do Empregador:
( 89 comentários ) Dubai, United Arab Emirates

ID do Projeto: #583912

Premiar a:

ichurakov

Please check inbox. Thnx.

$30 USD em 0 dias
(215 Avaliações)
6.3

10 freelancers estão ofertando em média $82 para este trabalho

phpexp

Please check the PMB. Ready to start

$30 USD in 0 dias
(186 Comentários)
8.0
ranacseruet

I can do it...

$70 USD in 2 dias
(38 Comentários)
5.8
shihab03

Hello Sir, we are some experts working together for a long time and have done a several types of projects. we give the preference on quality and the out look of the project so that a customer can be impressed easily Mais

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5.8
QualityGraphics

Please check PMB. Thanks

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5.6
phil999

please check PM

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5.5
developer99

Ready to start now

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4.5
univane

Hi, Please check PM. Thanks.

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4.4
PlaceTalent

Ready to start ASAP. Please check Inbox for more detials.

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3.3
customwebsoft

Please check [url removed, login to view]

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