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Survey type selection script

PLEASE NOTE THAT TIME IS A CRITICAL COMPONENT OF THIS BID. IF YOU CAN NOT COMPLETE WITHIN 24 HOURS OF AWARD, PLEASE DO NOT BID

We need a Survey Like input form for our site that does the following:

Web visitor will be able to select the from the following questions. Input for all of the questions is required:

- Are you:

Male

Female

Age:

18 to 25

26 to 34

35 to 44

45 to 54

55 or over

Do You Currently Smoke?

Yes

No

Do You Drink Coffee?

Yes

No

Now go to:

<[url removed, login to view]>

We would like to have the What Shade Are Your Teeth (upper right) question, with the different shades shown.

How Soon Do You Want To Results

Zip Code

When the press enter, they will then be directed to a new page.

Need to be able to frame the above in a webpage

## Deliverables

1) Complete and fully-functional working program(s) in executable form as well as complete source code of all work done.

2) Deliverables must be in ready-to-run condition, as follows (depending on the nature of the deliverables):

a) For web sites or other server-side deliverables intended to only ever exist in one place in the Buyer's environment--Deliverables must be installed by the Seller in ready-to-run condition in the Buyer's environment.

b) For all others including desktop software or software the buyer intends to distribute: A software installation package that will install the software in ready-to-run condition on the platform(s) specified in this bid request.

3) All deliverables will be considered "work made for hire" under U.S. Copyright law. Buyer will receive exclusive and complete copyrights to all work purchased. (No GPL, GNU, 3rd party components, etc. unless all copyright ramifications are explained AND AGREED TO by the buyer on the site per the coder's Seller Legal Agreement).

## Platform

php

Habilidades: Amazon Web Services, Interface do usuário / AI

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Acerca do Empregador:
( 99 comentários ) Adel, United States

ID do Projeto: #2847758

5 freelancers estão ofertando em média $62 para esse trabalho

corelabd

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$63.75 USD em 1 dia
(9 Comentários)
3.6
Sincronsoft

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FantasticCoder

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kseen

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vw7111611vw

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$85 USD em 1 dia
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