Em Andamento

php enquiry form

Hi Im looking for a design for a secure php enquiry form that I can use in a future project. The form will be completed and then emailed to the address I will fill in when the form is used. I need this doing in the next hour or two if possible.

A date picker is required for the date

I need the following fields.

Name (text field)

address (text area)

telephone (text field)

place of service (text field)

venue (text field)

Interested in

car1 (check box)

car2 (check box)

car3 (check box)

car4 (check box)

Habilidades: PHP

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Acerca do Empregador:
( 81 comentários ) manchester, United Kingdom

ID do Projeto: #128651