Hi
I need a form created in PHP and willing to pay 200F$ for one to be completed to the following specs (I’ve tried to supply everything you need).
Specs:
All sections marked * must be required fields.
From must be php and will send all completed info in a simple but nicely formatted mail to:
mail@kandyxchange.info
Once completed form will forward to this page:
http://www.kandyxchange.info/formthanks.htm
Submitting the form when not completed in all required fields can give a warning in a pop up or forward to:
http://www.kandyxchange.info/formerror.htm
The form code should be inside a table so I can simply paste it into a ready prepared .html page.
The form should be neatly presented.
If you need any further info or anything is unclear please let me know – cheers!
----------(START OF FORM)---------------------
*Title:
(Drop Down menu)
Options-
Mr (default)
Mrs
Miss
Ms
Dr
Prof
Rev
Lord
Lady Sir
Dame
Other
If Other Please Specify:
(Text Box)
*Given Name/Forename:
(Text Box)
*Family Name/Surname:
(Text Box)
*Permanent Home Address:
(Text Box)
Second Line of Address:
(Text Box)
*Town:
(Text Box)
*City/County/State:
(Text Box)
*Post/Zip Code:
(Text Box)
*Country
(Drop Down Menu)
Options-
Select your country… (default)
Afghanistan
Åland Islands
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Congo,the Democratic Republic of the
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands (Malvinas)
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See (Vatican City State)
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran, Islamic Republic of
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libyan Arab Jamahiriya
Liechtenstein
Lithuania
Luxembourg
Macao
Macedonia, the Former Yugoslav Republic of
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova, Republic of
Monaco
Mongolia
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestinian Territory, Occupied
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Réunion
Romania
Russian Federation
Rwanda
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia and Montenegro
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Swaziland
Sweden
Switzerland
Syrian Arab Republic
Taiwan, Province of China
Tajikistan
Tanzania, United Republic Of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
United States Minor Outlying Islands
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
*Telephone including Country Code
(Text Box)
*Email
(Text Box)
*Date of Birth:
dd (Drop Down Menu) mmm (Drop Down Menu) Year (Text Box)
-Options (dd)
dd (default)
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
-Options (mmm)
mmm- default
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
“Gender:-Options
Male (Tick Box) Female (Tick Box)
Notes Special Requests:
(Text Area)
Legal Requirements (please tick all that apply):
*(Tick Box) I wish to become a member of the Kandy X Change Club
*(Tick Box) I have read & agree with all the Latest Terms & Conditions of membership
* (Tick Box) I am 16 years of age or over.
* (Tick Box) I confirm all information provided to be true and understand it is a criminal offence to supply false information.
* (Tick Box) I understand Kandy X-Change retains the right to pass my details to authorities in the event of a civil or legal case being made against me as a result of my membership of Kandy X-Change.
APPLY (button) CLEAR (button)
----------(END OF FORM)---------------------
Thanks guys!
I need a form created in PHP and willing to pay 200F$ for one to be completed to the following specs (I’ve tried to supply everything you need).
Specs:
All sections marked * must be required fields.
From must be php and will send all completed info in a simple but nicely formatted mail to:
mail@kandyxchange.info
Once completed form will forward to this page:
http://www.kandyxchange.info/formthanks.htm
Submitting the form when not completed in all required fields can give a warning in a pop up or forward to:
http://www.kandyxchange.info/formerror.htm
The form code should be inside a table so I can simply paste it into a ready prepared .html page.
The form should be neatly presented.
If you need any further info or anything is unclear please let me know – cheers!
----------(START OF FORM)---------------------
*Title:
(Drop Down menu)
Options-
Mr (default)
Mrs
Miss
Ms
Dr
Prof
Rev
Lord
Lady Sir
Dame
Other
If Other Please Specify:
(Text Box)
*Given Name/Forename:
(Text Box)
*Family Name/Surname:
(Text Box)
*Permanent Home Address:
(Text Box)
Second Line of Address:
(Text Box)
*Town:
(Text Box)
*City/County/State:
(Text Box)
*Post/Zip Code:
(Text Box)
*Country
(Drop Down Menu)
Options-
Select your country… (default)
Afghanistan
Åland Islands
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Congo,the Democratic Republic of the
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands (Malvinas)
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See (Vatican City State)
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran, Islamic Republic of
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libyan Arab Jamahiriya
Liechtenstein
Lithuania
Luxembourg
Macao
Macedonia, the Former Yugoslav Republic of
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova, Republic of
Monaco
Mongolia
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestinian Territory, Occupied
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Réunion
Romania
Russian Federation
Rwanda
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia and Montenegro
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Swaziland
Sweden
Switzerland
Syrian Arab Republic
Taiwan, Province of China
Tajikistan
Tanzania, United Republic Of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
United States Minor Outlying Islands
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
*Telephone including Country Code
(Text Box)
(Text Box)
*Date of Birth:
dd (Drop Down Menu) mmm (Drop Down Menu) Year (Text Box)
-Options (dd)
dd (default)
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
-Options (mmm)
mmm- default
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
“Gender:-Options
Male (Tick Box) Female (Tick Box)
Notes Special Requests:
(Text Area)
Legal Requirements (please tick all that apply):
*(Tick Box) I wish to become a member of the Kandy X Change Club
*(Tick Box) I have read & agree with all the Latest Terms & Conditions of membership
* (Tick Box) I am 16 years of age or over.
* (Tick Box) I confirm all information provided to be true and understand it is a criminal offence to supply false information.
* (Tick Box) I understand Kandy X-Change retains the right to pass my details to authorities in the event of a civil or legal case being made against me as a result of my membership of Kandy X-Change.
APPLY (button) CLEAR (button)
----------(END OF FORM)---------------------
Thanks guys!
