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131577 Terms & Conditions Web Form

I need a web form that sends data to an e-mail address AS WELL AS POSTS confirmation on the next page for the user to print


I need it to send the data to an e-mail address as well as post on a confirmation page so the user can print the details along with the terms and conditions (T/C).

The form fields are as follows:

Contact Name:

Company Name:

Street Address:



Zip Code:

Phone #:

Fax #:



Terms & Conditions Box (text within a 3-4inch box where someone can choose to read if they scroll down within the frame of the box) ... they then check the box if they agree to the T/C. and they press submit. The T/C box on the form page will be boxed in and shaded gray with the ability to scroll.

It will take them to a page where their data is posted as well as the full T/C which can be printed. (The submit form will take them to an HTML/php page where they can print out the form they just agreed to with the company logo on top w/ their info and then the full T/C's).

Private Message me and I will send over link for site and location for form.

Kĩ năng: Bất kì công việc gì, Javascript, Perl, PHP, Thiết lập Bản thảo

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Về Bên Thuê:
( 37 nhận xét )

ID dự án: #1877746

Được trao cho:


I can begin work on this tonight and finish by tomorrow.

$55 USD trong 1 ngày
(120 Đánh Giá)