Replicate a form on a web page

Fertiggestellt Veröffentlicht vor 7 Jahren Bezahlt bei Lieferung
Fertiggestellt Bezahlt bei Lieferung

Need a working copy of the form on this web page:

[login to view URL]

Requirements:

- HTML5 - W3C - Responsive

- Only the form is necessary not the menus around

- See attached picture for reference, this is how the final web page should look like

(the 3 sections need to be fully working)

- Needs to be done:

a) The 3 submit button needs to be working, sending all fields to a "fictive" PHP page.

b) Sections selector must be fully working ("inscription" / "modification" / "retrait")

c) Only 3 phone numbers fields are neccessary, not 5

d) SQL injection prevention

(fields all needs to be validated for valid characters within javascript)

I should be able to upload the form to a web server and create the PHP page by myself that will accept the form submissions, and assume that all will be validated and working fine.

Thank you!

HTML JavaScript PHP Webdesign

Projekt-ID: #11626990

Über das Projekt

33 Vorschläge Remote Projekt Aktiv vor 7 Jahren

Vergeben an:

$74 USD in 2 Tagen
(266 Bewertungen)
7.3

33 Freelancer bieten im Durchschnitt $147 für diesen Job

rexzetsolutions

with guranty within 24 to 48 hours i will close this project and form will be worked following all conditions that you mentioned in the project

$150 USD in 2 Tagen
(316 Bewertungen)
7.4
ecommercejui

Hi , Let’s start. I am highly interested to work on this project. I understand your requirements. I am 100% sure I can complete within timeline with quality Regards Jui

$155 USD in 3 Tagen
(123 Bewertungen)
6.9
isensebd

Hello In the reference site I can see 3 form for 3 different section? Do you need all these 3 form fields? You also mentioned about the validation. Do you mean number validation or any other special validation? More Mehr

$120 USD in 3 Tagen
(122 Bewertungen)
6.9
seefattechnologi

Dear Hiring Manager, Greeting! Thanks for your job posting, I would like to work on this project with you on the required conditions that you have provided in your description. I have been keenly waiting for th Mehr

$150 USD in 3 Tagen
(71 Bewertungen)
6.5
itpathsolutions

Rather than long description , You can see our ratting and reviews. We have expertise developers in PHP and we can be your helping hand in your task as per your requirements. Let's discuss in Private. (*Have P Mehr

$175 USD in 3 Tagen
(38 Bewertungen)
6.3
hasanjack

vHi sir I am Hasan Jack and I have more than 5 years of experience in Web Development. As because of my prior experience I really feel I can be best choice for this job. Looking forward to hear from you. Regards, Mehr

$250 USD in 3 Tagen
(56 Bewertungen)
6.3
amangpt145

I have 6 Year Experience of Web Designing / Developing and i have completed many project successfully... I also have a great designing team .... We Work On following technology : PHP,Mysql,Joomla,Magento,Wordpress, Mehr

$110 USD in 3 Tagen
(66 Bewertungen)
6.4
ssmlrehan0

Hello Good Day ... I will surely Replicate a form on a web page as per your requirements I am fully available to do this task, and surely deliver you in 2 days As it will be my first task with you, As a bonus, I ag Mehr

$66 USD in 2 Tagen
(81 Bewertungen)
6.3
maxtechsl

Hello, I am ready to implement the form which can be integrated with your web page in a professional manner as per requirement. I have gone thro the attached picture and confident to custom implement to your satisfacti Mehr

$122 USD in 3 Tagen
(105 Bewertungen)
6.6
zahidsaeed96

Hello sir, allow me to complete the website. I'm have been developing websites and web applications for over 4 years now. I have worked with HTML5, CSS3, JS, Bootstrap, PHP, MySQL, jQuery, CodeIgniter and much more. I Mehr

$45 USD in 1 Tag
(75 Bewertungen)
5.7
apachefriends

Hi, I am interested in your project " Replicate a form on a web page ". Let's discuss more about the project and turn it into reality with your idea and our skills. We work on Website development, Mobile a Mehr

$111 USD in 3 Tagen
(13 Bewertungen)
5.7
whitealien

Hi! Bonjour, Salut! This looks like a straight forward project and I'd be happy to take this on and return it to you a day after starting, then I allow a couple of days in case messages back/forth are delayed. You Mehr

$186 USD in 5 Tagen
(14 Bewertungen)
5.1
niral51patel

Dear Sir, Greetings from Niral Patel, I gone through the detailed requirement and found that you are looking for someone who is experienced with PHP to replicate a form from reference site in fact i have visited Mehr

$100 USD in 2 Tagen
(30 Bewertungen)
4.9
allWebDesignPro

A proposal has not yet been provided

$55 USD in 2 Tagen
(5 Bewertungen)
4.1
markopu

i will do it in vanilla php and with some help of jquery on client side, exactly as you need it. i need 2 days to complete, 1 day for working version and 1 day for your testing and code cleanup. ping me if intere Mehr

$155 USD in 2 Tagen
(10 Bewertungen)
3.6
damasterbdz

Dear Hiring Manager, First of all thanks for creating an opportunity. Hope you are doing well. I will not propose what the maximum Freelancer do. I dont believe in copy paste Cover letter. I read your project details, Mehr

$222 USD in 5 Tagen
(23 Bewertungen)
5.4
ignore1

Easy task, may finish it in one day, but as noobie here i'd like to ask for 1,5 days =) As I understand you need minor fixies and improvements in form using only css and html5 - at's no problem )

$30 USD in 2 Tagen
(0 Bewertungen)
0.0
orlandochirinosa

System Analyst with experience in: • Analysis, design, development and maintenance of web systems. • Design, programming and database management. • Analysis and optimization of internal processes. • Development of Mehr

$111 USD in 10 Tagen
(0 Bewertungen)
0.0