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creating web form for a newsletter (Simple Project)

I have mailing software from Omnistaret, I need to add a simple webform for user to sign up, it is ready and can be gennerated automaticlly, but the problem that i need it to be in Arabic, and everytime i put it gave me an error

so i need some one to fix the problem

here is the example

[url removed, login to view]

the second field is "Age"

the hosting company is hostgator

Kĩ năng: Thiết kế đồ họa, HTML, MySQL, PHP, Thiết kế trang web

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Về Bên Thuê:
( 18 nhận xét ) London, Egypt

ID dự án: #1629638

Được trao cho:

spotlayer

hello egycorner We Have Gone through your requirement and understood, we are very sure that we can do your needs with your entire satisfaction. We have left a PMB for you plz feel free to have a look over there.

$30 USD trong 0 ngày
(5 Đánh Giá)
3.6

17 freelancer đang chào giá trung bình $57 cho công việc này

becomeexpert

Let me do it right now. Waiting for your selection to proceed on. Thanks.

$30 USD trong 1 ngày
(192 Nhận xét)
7.7
seekdeveloper

Hi, Kindly check PMB

$250 USD trong 1 ngày
(72 Nhận xét)
7.5
gopalvora

ready to start Thanks

$30 USD trong 1 ngày
(276 Nhận xét)
7.4
ExcellenceonPHP

LETS DO IT RIGHT [login to view URL]

$35 USD trong 0 ngày
(210 Nhận xét)
6.9
expertonphp

Hello Sir, We have understood your requirements and can do this job very easily. We have 5+ years of experience in Web Development. We assure you that we will provide you quality work at reasonable prices. Thanks!

$30 USD trong 1 ngày
(106 Nhận xét)
6.3
MinaAlfy

Please check your PM

$30 USD trong 1 ngày
(43 Nhận xét)
5.4
tooltor

Expert developer here, please read the private message.

$30 USD trong 1 ngày
(45 Nhận xét)
5.3
webedict

HELLO SIR, READY TO START. LETS START AND FINISH IT ASAP. I HAVE 3 YEARS OF EXPERIENCE IN PHP, MYSQL, AJAX, JAVASCRIPT, XHTML. THANKS !!

$30 USD trong 0 ngày
(63 Nhận xét)
5.2
jasoncar

This seems pretty straightforward. Please see message attached.

$30 USD trong 2 ngày
(3 Nhận xét)
5.3
MakeYouBelieve

Hi, I can do it for you. Regards.

$30 USD trong 0 ngày
(48 Nhận xét)
4.8
zakir375

We have a team of Web Developers with over 5 years experience, please see PMB for more details.

$30 USD trong 2 ngày
(8 Nhận xét)
4.5
SourcerersInc

I have an easy solution for your problem if contacted I can take care it for less than a day.

$30 USD trong 1 ngày
(0 Nhận xét)
0.0
rohittank

Hello i can do this very easily and also i have done many project like this

$30 USD trong 0 ngày
(0 Nhận xét)
0.0
J5W7B9jRf

<b><i>Removed by Admin</i></b> - Custom software development - skpye: <b><i>Removed by Admin</i></b>

$250 USD trong 1 ngày
(0 Nhận xét)
0.0
iamvasim

skype : vasim_padhiyar

$40 USD trong 1 ngày
(0 Nhận xét)
0.0
samtechs

Ready to work with you please check PMB

$30 USD trong 1 ngày
(0 Nhận xét)
0.0