Hello,

I need a form that will return the following information to an email address via submit button:
Name
Address
City
State
Zip
Email

I need to add it to the following page:
http://www.mccandlishdesign.com/contact.html

Questions for Freelancers
1. How many hours will this take?
2. How soon can you complete the job?
3. Will the code be easy for me to install? and edit/customize?

Proposals

Provider Location Amount ($35)
Vinkesh   India SEAL
LiveBrain Technology   India SEAL
pritesh   India SEAL
Additional Specification
Status : Closed
Expired on : 6 years ago
Country :   USA
Estimate Budget : Not Decided

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