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142290 Multi-page mortgage form

I need a three page form that gets the following information from surfers and asks different questions depending on what kind of loan it is:

Page 1

--------

-What kind of loan (refi, new home, home equity)

-Type of Home (single family, multi-family, condo, townhome)

-Credit Profile (excellent, good, bad, poor)

If they choose refi, then ask these questions on Page 2:

-Property location (list of states)

-How property is used (primary residence, second home, investment)

-Loan purpose (lower monthly payment, lower interest rate, change loan terms, pay off debt, home improvements, take out cash)

-First mortgage balance

-First mortgage interest rate

-Rate type (fixed, adjustable, don't know)

-Do they have a second mortgage (yes or no)

-How much extra cash do you want

If they choose new home, then ask these questions instead on page 2:

-Property location (list of states)

-How property will be used (primary residence, second home, investment)

-When will they buy (immediately, 30 days, 60 days, 90 days, no timeframe)

-Do they have a real estate agent (yes/no)

-Estimated home value

-Down payment amount

-Rate type (fixed, adjustable, don't know)

If they choose home equity, then ask these questions instead on page 3:

-Property location (list of states)

-How property is used (primary residence, second home, investment)

-Loan purpose (lower monthly payment, lower interest rate, change terms, pay off debt, home improvements, take out cash)

-First mortgage balance

-First mortgage interest rate

-Rate type (fixed, adjustable, don't know)

-Do they have a second mortgage

-How much cash do they want for the home equity loan

Page 3

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-First Name

-Last Name

-Street Address

-City

-State

-Zip

-Email address

-Primary phone

-Secondary phone

-Best time to call (morning on primary, afternoon on primary, evening on primary, morning on secondary, afternoon on secondary, evening on secondary)

So to clarify, show the same page 1 and page 3 to everyone...but change page 2 based on whether they want refi, new home, or home equity.

I then need the form to be submitted to an external server. I will give you documentation with a list of variable names and allowed values. The external server has javascript which can verify input before the lead is submitted, and I can give you the source for this if you need. I would rather you use their hosted .js to verify the lead.

The form should look clean (I can give you some example URL's) and professional. It does not have to be beautiful, and there is no graphic design neccessary for this project. The only graphics neccessary are an arrow pointing to the form and a submit button (not just an html button, a .gif/.jpg that says submit on it). The form also should have 1, 2, and 3 on top- letting the surfer know which page they're on. Use a simple graphic to do this, with the current page's number highlighted.

Do not use cookies or sessions to keep track of the state. Just use PHP and input type hidden forms in your html.

The external server is expecting test leads, so I can communicate with you as to whether or not they are being submitted correctly.

Kỹ năng: Bất kì công việc gì, PHP

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Về Bên Thuê:
( 15 nhận xét ) Midland Park, United States

Mã Dự Án: #1888465

Đã trao cho:

claudiurogoveanu

I can do it for you. I'll also make the form be psoted to your remote server! Thanks

$90 USD trong 2 ngày
(62 Đánh Giá)
5.2