Floating Window With Contact Form
Required skills: PHP, Programming, Java, Contact Form, Form
I have a web page that is online. Please see www.smilebritelabs.com
What we need done is to have
1. a floating window (a new window apprear and the background dim to black. once the submit button is clicked a confermation message appears that says sucsseful or unsucsseful then return to the main page. appear when the link "Pick Up Case" link is clicked. On the floating window we need to have a contact form that asks for
Title says Schedule a pick up now!
A. Doctor/Office name:
B. Office phone Number:
C. Email address: (this will need to have an auto responder to send an confermation email to them stating that they have sucsefully requested a pick up.
D. Case is ready: have the options of now, or by time: then a field to place the time.
Then a submit button and clear button.
all of this data will nee to be sent to my email address.
2.I need a secound contact form created on our contact us page.
what I need in the contact form
a. Office name
b. Doctor name
c. Address
d. City
e. State
f. zip
g. Office phone number
h. Office email address
1.(check box) Please contact me about your lab.
2. Order supplies (Drop down box with, Lab slips, Boxes, Bags, Shipping labels, product infomation)
3. please send me more infomation.
4. Notes box
We would like to have the contact form be the smae look and style as our curent page.
I am looking to get this completed ASAP.
Please let me know when you will be able to complete this project.
Thanks
What we need done is to have
1. a floating window (a new window apprear and the background dim to black. once the submit button is clicked a confermation message appears that says sucsseful or unsucsseful then return to the main page. appear when the link "Pick Up Case" link is clicked. On the floating window we need to have a contact form that asks for
Title says Schedule a pick up now!
A. Doctor/Office name:
B. Office phone Number:
C. Email address: (this will need to have an auto responder to send an confermation email to them stating that they have sucsefully requested a pick up.
D. Case is ready: have the options of now, or by time: then a field to place the time.
Then a submit button and clear button.
all of this data will nee to be sent to my email address.
2.I need a secound contact form created on our contact us page.
what I need in the contact form
a. Office name
b. Doctor name
c. Address
d. City
e. State
f. zip
g. Office phone number
h. Office email address
1.(check box) Please contact me about your lab.
2. Order supplies (Drop down box with, Lab slips, Boxes, Bags, Shipping labels, product infomation)
3. please send me more infomation.
4. Notes box
We would like to have the contact form be the smae look and style as our curent page.
I am looking to get this completed ASAP.
Please let me know when you will be able to complete this project.
Thanks
Posted In:PHPProgrammingJava |
Related projects:
Floating Window With Contact Forms
phone number
h. Office email address
1.(check box) Please contact me about your lab.
2. Order supplies (Drop down box with, Lab slips, Boxes, Bags, Shipping labels, product infomation)
3. please send me more infomation.
4. Notes box
We would like to have the contact form be the smae look and style as our curent page.
I am looking to get this completed ASAP.
Please let me know when you will be able to complete this project.
Thanks
h. Office email address
1.(check box) Please contact me about your lab.
2. Order supplies (Drop down box with, Lab slips, Boxes, Bags, Shipping labels, product infomation)
3. please send me more infomation.
4. Notes box
We would like to have the contact form be the smae look and style as our curent page.
I am looking to get this completed ASAP.
Please let me know when you will be able to complete this project.
Thanks
Single Page Website With Contact Form
Single page website with contact form required artwork to be supplied by me in AI format so you may amend .
Price list to form some of the website or avalible for download on PDF as a link.
Add into site made by The Local Explorer and link to our site
Price list to form some of the website or avalible for download on PDF as a link.
Add into site made by The Local Explorer and link to our site
Website with Contact Form
e art work also
I like this template: http://www.techknowls.com/
Additional information submitted: 12/13/2009 at 14:19 EST:
I ALSO NEED A LOGO DONE. SIMPLE ONE
I like this template: http://www.techknowls.com/
Additional information submitted: 12/13/2009 at 14:19 EST:
I ALSO NEED A LOGO DONE. SIMPLE ONE
5 page design with Flash Banner with contact form
5 page design with Flash Banner with contact form.
For Attorney
For Attorney
4 page website with contact form - for Mauricio
Create 4-page website from template I have, text I have, and pictures I have, with contact form. PHP is enabled on the server.
Convert PSD files to fully functional website on a free CMS with contact form and portfolio page and be SEO friendly
fferent content but same design, portfolio -1 page, contact form 1 page.
Please feel free to ask question.
I am not sure what else to put, can be discussed in ICQ
Project files would be sent upon request
Job needs to be highest quality
If needed, ready to increase the budget after discussion
Ready to pay a high price, but everything needs to be perfect
Please have a portfolio,
A lot more projects coming
Reasonable prices
Good luck
Please feel free to ask question.
I am not sure what else to put, can be discussed in ICQ
Project files would be sent upon request
Job needs to be highest quality
If needed, ready to increase the budget after discussion
Ready to pay a high price, but everything needs to be perfect
Please have a portfolio,
A lot more projects coming
Reasonable prices
Good luck
Contact Form
need a contact form to send admin html mail exactly like attached image, but with extra field "contact number".
So 4 fields: name, email, contact number, message.
Also, send a "thank you" message to sender.
This is a simple job should take any gd coder 1 hour
Max bid 17 USD.
So 4 fields: name, email, contact number, message.
Also, send a "thank you" message to sender.
This is a simple job should take any gd coder 1 hour
Max bid 17 USD.
Wordpress Plugin Contact Form
milar to existing plugins. Once contact form is saved a table will be created just for that form with fields that are the same as contact form fields.
Once the form is submitted the admin can view forms in admin sidebar with little numbers for new submissions. Once admin clicks on form the admin can then view/sort/delete/export form submissions on a per form basis.
Please contact me on the PMB for any questions, this will be an on going project to keep it current with WP.
Once the form is submitted the admin can view forms in admin sidebar with little numbers for new submissions. Once admin clicks on form the admin can then view/sort/delete/export form submissions on a per form basis.
Please contact me on the PMB for any questions, this will be an on going project to keep it current with WP.
Psd To Html + Css And Ajax Contact Form Needed Asap
ll provide all the graphics.
3 Pages include a homepage and 2 content pages,
We need this to be compatible with all browsers.
1. psd to html,CSS - 3 pages
2. contact form - when you click contact us, a dropdown ajax form is needed.
4 fields with validation: name, email, phone, Message box. all fields except phone are required fields.No database work.
form will send me the message and send a confirmation email to user. also a Thank you message on submit.
3 Pages include a homepage and 2 content pages,
We need this to be compatible with all browsers.
1. psd to html,CSS - 3 pages
2. contact form - when you click contact us, a dropdown ajax form is needed.
4 fields with validation: name, email, phone, Message box. all fields except phone are required fields.No database work.
form will send me the message and send a confirmation email to user. also a Thank you message on submit.
Static HTML website 40 pages with contact form
I exported a PDF. I do not know if we can get the CS3 since it is so large.
Please post a PM that you've considered this project and you have intelligent questions. I ignore all copy and paste PM that has hundreds of website URLS... I do not read them.
Payment through Freelancer escrow only and I will break it into 2 or 3 payments if you want.
Please post a PM that you've considered this project and you have intelligent questions. I ignore all copy and paste PM that has hundreds of website URLS... I do not read them.
Payment through Freelancer escrow only and I will break it into 2 or 3 payments if you want.
Simple Html/css Work Along With Contact Form
I have an url of a static site that I want cloned, this includes HTML/CSS along with configuring a simple contact form. Should take no more than 1.5 hour or less to finish.
Please look at document where I outline all the task. There is no design involved.
Will only choose if you agree to work on project immediately. DO NOT BID IF YOU WILL GOING TO SLEEP SOON!!!!
Please look at document where I outline all the task. There is no design involved.
Will only choose if you agree to work on project immediately. DO NOT BID IF YOU WILL GOING TO SLEEP SOON!!!!
Single Page Website With Contact Form
e files so you may view before bidding .
http://max.mailbigfile.com/c619db2b1244e4bacdf511bd4ebb1896/listFiles.php
When bidding please message via script lance some examples of work
Many Thanks
http://max.mailbigfile.com/c619db2b1244e4bacdf511bd4ebb1896/listFiles.php
When bidding please message via script lance some examples of work
Many Thanks
NyroModal Window HTML contact form
mat)
Phone number (with formatting)
Company Name
Number of employees
Areas of Interest (check boxes)
Health & Wellness Programs
Flexible Spending Account (FSA)
Health Reimbursement Account (HRA)
Health Savings Account (HSA)
Self-Insured Health Plans
COBRA Administrative Services
Workers' Compensation
Physician Recruitment
Comments (Free-form text)
Phone number (with formatting)
Company Name
Number of employees
Areas of Interest (check boxes)
Health & Wellness Programs
Flexible Spending Account (FSA)
Health Reimbursement Account (HRA)
Health Savings Account (HSA)
Self-Insured Health Plans
COBRA Administrative Services
Workers' Compensation
Physician Recruitment
Comments (Free-form text)
Php Contact Form Broken - Fix Needed
I have an existing website for my business.
The contact form is no longer working.
I need it fixed QUICKLY - within 24 hours.
I am available immediately and I need you to be as well.
Contact me if you are interested.
Thanks.
The contact form is no longer working.
I need it fixed QUICKLY - within 24 hours.
I am available immediately and I need you to be as well.
Contact me if you are interested.
Thanks.
Website With A Small Db 2
Hello,
I need a small website with contact form, multilanguage, and a database. Clients would login and check their transaction status. Automated tracking numbers should be generated.
Also need a feature to notify Clients with instant emails.
Example site careposit.com
I need a small website with contact form, multilanguage, and a database. Clients would login and check their transaction status. Automated tracking numbers should be generated.
Also need a feature to notify Clients with instant emails.
Example site careposit.com
Quick Contact Form Needed 2 2
Hi guys. I need a PHP contact form using Google Captcha created. I will have some 20 fields or so. I'll provide the template that must be used, you'll insert/create the needed code. Some limitations must be set on the fields as well.
This should be a 2-3 hours maximum job for a good programmer. Please keep your bids low, thank you!
This should be a 2-3 hours maximum job for a good programmer. Please keep your bids low, thank you!
Website With A Small Db
Hello,
I need a small website with contact form, multilanguage, and a database. Clients would login and check their transaction status. Automated tracking numbers should be generated.
Also need a feature to notify Clients with instant emails.
Example site careposit.com
I need a small website with contact form, multilanguage, and a database. Clients would login and check their transaction status. Automated tracking numbers should be generated.
Also need a feature to notify Clients with instant emails.
Example site careposit.com
Quick Contact Form Needed 2
Hi guys. I need a PHP contact form using Google Captcha created. I will have some 20 fields or so. I'll provide the template that must be used, you'll insert/create the needed code. Some limitations must be set on the fields as well.
This should be a 2-3 hours maximum job for a good programmer. Please keep your bids low, thank you!
This should be a 2-3 hours maximum job for a good programmer. Please keep your bids low, thank you!
Create Wordpress Contact Form Plugin
/J15Pbi" target="_blank" rel="nofollow">http://bit.ly/J15Pbi
I like the rounded corners and the captcha verification.
The plugin will need a simple admin settings page.
All code must be written by you, do not plagiarize or copy code from anywhere.
Also, I might need you for future updates, but we can work out a deal on that later.
When you place a bid, tell me how long it will take you to get a working version ready.
Thanks
I like the rounded corners and the captcha verification.
The plugin will need a simple admin settings page.
All code must be written by you, do not plagiarize or copy code from anywhere.
Also, I might need you for future updates, but we can work out a deal on that later.
When you place a bid, tell me how long it will take you to get a working version ready.
Thanks
Fix My Contact Form
Just need to fix contact form. Not sure why it's not working. Pretty simple and quick.
