Web Form to post, forward and autoreply

In Progress

Looking to outsource a web form that will post data to MySQL, forward the same data via email to an internal contact as well as autoreply to the enduser with one or two file attachments.

Specs:

Languages:

FLASH / PHP or HTML / CGI

Database

MySQL

Files to be emailed

ZIP

Detailed Specs:

A form, listing pertinant contact info (ie: name, title, company, contact phone, contact email) as well as the option to select (via radio button) A, B (send me more information about A. Coffee, B. Beer) or both. Once submitted, data will post to a MySQL database as well as forward an email to marketing. Furthermore, an autoreply will be generated sending an email to the registrant/end user with file attachments with information pertaining to A, B, or both.

I have attached a sample image of the form for your review.

I look forward to a prompt reply.

Skills: Adobe Flash, PHP

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Project ID: #12

Awarded to:

phpexpert

I have read the specs about your form carefully, and I think it is very simple task for me to complete in 3 days. As I have more than 3 Years of Expertise in PHP/ MYSQL / APACHE. Regrds Shafiq http://www.phpgurru. More

$100 USD in 3 days
(1 Review)
2.6

12 freelancers are bidding on average $167 for this job

arun07

Can be done. If interested than pls let me know. I will charge 20% before starting the project so have this in mind before selecting me. For my previous projects have a look at my profile.

$200 USD in 5 days
(3 Reviews)
2.4
Gravitas

Dear Sir, We are Pune(India) based Software Development Company . We specialize in website design, ,application development and data conversion.projects. We have successfully designed and developed many projects i More

$200 USD in 15 days
(0 Reviews)
0.0
samtech

We can do it very soon. We have a good team with PHP/Mysql expertise.

$100 USD in 3 days
(0 Reviews)
0.0
bjn

it\\\'s a small peice of job and i can do it easily.

$30 USD in 1 day
(0 Reviews)
0.0
mgcarley

One of New Zealands Premiere Web Solution Providers. Web Hosting, Web Design and maintenance services. With us, you will be backed by top-notch service and support for all your IT needs. Based in Hamilton, the heart of More

$500 USD in 3 days
(0 Reviews)
0.0
aliahmad

Sir, I will do ur projects my hotmail address is xxxxxx@xxxxx.xxx

$250 USD in 5 days
(0 Reviews)
0.0
Harish

I have seen the form and understood your requirement and I think it\'s work for atleast & days. I can assure you the best quility and creativity, I can give some more idea to increase the Look and Usability.

$190 USD in 7 days
(0 Reviews)
0.0
msaqibansari

I have understood your requirement and I will deliver it in a day.

$50 USD in 1 day
(0 Reviews)
0.0
sreejithks

Will be able to deliver in 3 days.

$100 USD in 3 days
(0 Reviews)
0.0
vsurabhi

Looked at the form that you had uploaded looks simple enough. We will give additional detail to the formatting and the usability of the web pages. Preffered scripting php. Database MySQL.

$250 USD in 5 days
(0 Reviews)
0.0