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146117 Script to capture visitor info

I want a php script written which generate a form will capture the following visitor information: First Name,Middle Name,Last Name,Current Name,Gender,Birthdate,e-mail. This information is then to be e-mailed to a configurable e-mail address. A button at the bottom of the form will active a checking process to ensure all data is entered correctly. I will supply some code and some screenshots showing the look and feel of the form.

This should not take long for a seasoned PHP programmer.

Kỹ năng: Bất kì công việc gì, PHP

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Về Bên Thuê:
( 1 nhận xét ) Southampton, United Kingdom

Mã Dự Án: #1892294

Đã trao cho:

alesix

Please refer to the project message board. (Changed Bid)

$100 USD trong 2 ngày
(65 Đánh Giá)
5.3