I need a database form on my site

I need a form on my website - I call prospects on the phone, qualify them then pass them along to a debt company I'm working with. 1. I want to fill out a one-page form on a web page as I'm qualifying the prospect. I have a list of the data fields - standard stuff - name, address, phone, email etc. 2. I forward the call to my client - a debt settlement company. The call is answered by one of his debt counselors. 3. I tell the debt counselor: "This is Mike Banks. I have Mary Smith on the line. Mary's phone number is 215-345-5442" 4. The debt counselor enters the phone number on a page which takes him to the form I filled out. I have a detailed overview. Please get in touch and I'll email it to you. Be sure and include your phone number please. Thanks Michael Banks e: mbanks@[url removed, login to view] v: 805-569-2678

## Deliverables

I'd like the coder to be U.S. based only. Thanks Michael mbanks@[url removed, login to view]

Kĩ năng: Kĩ thuật, MySQL, PHP, Quản lí dự án, Kiến trúc phần mềm, Kiểm tra phần mềm, Web Hosting, Quản lý website, Thử nghiệm trang web

Xem nhiều hơn: need a one page web site, michael smith, call mike, call michael, my phone number, i need a project, i need a website coder, touch site, need email database, need a company name, mike d, i need a web coder, Debt Settlement, counselor, company overview i, database name email phone number, banks email address list, fill form data site, database based web page, mike smith, email list banks, phone number address database, need database list, prospects database, tell form

ID dự án: #3817831