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Referral Submission Form (PHP and MySQL)

Referral Submission Form (PHP and MySQL)

We are looking for a developer to build a Client Referral Submission Form with the fields shown below. The tricky part is that the client doesn't know how many referrals they will want to make, so we are looking for easy ways to repeat the form depending on the number of referrals the user wants to submit. Ideas?

Please provide an estimate of what it would cost to create this form and simple database. If possible, we would like the output to be an Excel spreadsheet (emailed) for each referral (that includes the info on the person referring and the referral's info).

Requirements:

Must work on a Linux server using php and MySQL.

Please include approx turnaround time for this project.

Site creative will be provided.

Please post any questions via PM.

Fields include:

Your name

Company (need to try and place the referral at their company)

Your Phone

Your Email

Your Mailing Address (needed for contest winner)

I am referring the following colleagues...

Referral Name

Referral Email 1

Referral Email 2

Referral Phone

Referral Last Known Company

Referral Specialty - if known

Radio Button or Check box: Yes use my name when you contact this referral or No, please do not use my name

Thank You Page:

Thank you for your referrals! Your form has been successfully submitted and your name has been entered into the contest once for each referral on the form.

Habilidades: PHP

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Acerca do Empregador:
( 5 comentários ) Horsham, United States

ID do Projeto: #151266

Premiar a:

samaybhavsar

I can surely do this for you. Hoping for a positive reply. Please view PMB. Thanks

$150 USD em 2 dias
(13 Avaliações)
4.1

26 freelancers estão ofertando em média $145 para este trabalho

codersam

Please check your pmb for more details.... Thanks

$100 USD in 10 dias
(135 Comentários)
7.3
oscguy

I can get the simple task done quickly around 1 day, please check PMB to see what my PHP/MySQL/XHTML are

$150 USD em 1 dia
(25 Comentários)
7.0
arasferra

Lets do it now immediatly

$100 USD in 0 dias
(24 Comentários)
6.8
keyboard999

Hi. I can help you with this project.

$120 USD em 1 dia
(115 Comentários)
6.5
indyaportal

Greeting! Indyaportal is a professional web design company offers a wide range of services including professional web site design, web development, ecommerce, internet marketing, web site promotion services and corp Mais

$125 USD in 3 dias
(51 Comentários)
6.4
dice8up

We can get this done in 2-3 days.

$100 USD in 3 dias
(67 Comentários)
6.4
websoftinfo

lets start today.. regards meena

$100 USD in 0 dias
(66 Comentários)
6.4
msofredhi

Hello, we can help you =) Pls check your PMB. Many thanks!

$200 USD in 5 dias
(15 Comentários)
6.2
h114

hi, please have a look at pmb. regards,

$125 USD in 3 dias
(22 Comentários)
6.0
inteconssoftware

No Upfront, No Escrow, Pay after you have seen your job done on my test server Pls see pmb for details

$150 USD em 1 dia
(4 Comentários)
5.8
stephhw01

A VERY IMPORTANT OFFER IS WAITING FOR YOU IN YOUR PM !

$100 USD in 0 dias
(40 Comentários)
5.7
happyturtlecom

Dear Client: I can have this project done in less then 5 days. I can start right now. Please PM me more information about this project. Thanks, Dennis. PS: I am from the USA.

$200 USD in 5 dias
(38 Comentários)
5.5
EugeneB

Please check PMB. Thank you.

$120 USD em 1 dia
(45 Comentários)
5.2
dreamcorner

i can help you doing this project. please pmb

$200 USD em 1 dia
(27 Comentários)
4.9
programatphp

Hello, I am interested to do this job. I am serious and I give good atention to details. Kind regards, Andrew

$200 USD in 15 dias
(11 Comentários)
4.9
rguknet

Hi there, I'm an experienced PHP/MySQL developer and can have this done within 24 hours for you. Have already worked on several forms where the number of items to enter is not known. Please see PMB for more details. Mais

$100 USD in 0 dias
(8 Comentários)
4.1
eshristi

13 YEARS experienced Programmer with ~6 YEARS experience in PHP/Mysql development,Good reviews,Prompt delivery,assure dedicated service. For more details and ideas please check PMB. Thanks

$200 USD in 5 dias
(13 Comentários)
3.8
softprogrammer

Hi, Please check PMB. Thanks.

$100 USD in 4 dias
(2 Comentários)
2.9
Outlines

Hi, i am an experienced programmer in PHP/MySQL. Please check PM for furthur details.

$100 USD in 2 dias
(1 Comentário)
2.0
develophp

Hi, Please check your PM. Fred

$100 USD em 1 dia
(0 Comentários)
0.0