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One Page Form for Club Membership

I need someone to make a 1 page web from using the file provided for the look and feel. The fields are as followed:

name:

Address:

City:

State:

Zip:

email address:

Mac or PC:

How did you first hear of Enterprise Computer:

Friend, Yellow Pages, Newspaper, Coupon Book, Radio, TV, OTHER:

It must have a send button that emails it to me

and saves it to an Excel, tab delimted file on my website.

It will be located at [url removed, login to view]

Kỹ năng: Thiết kế trang web

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Về Bên Thuê:
( 8 nhận xét ) Clinton, United States

Mã Dự Án: #56152