Build a similar type form - R&D

We want a different way of doing forms - Coder will combine this page example [login to view URL] with the test data [login to view URL] to generate a simple price calculation in an html5 page. The task is to combine the two styles and calculations to create our new form. The final html5 page will be mobile friendly with questions and proper calculations must use font awesome icons (svg) instead of dropdowns. We like this style/format [login to view URL]

BUDGET $157 Max

Timeline to complete - deadline 4/days Max

** Auto responses will be deleted automatically - Use the word "Lobster" when you bid.

Will want to ask for the user's name, e-mail, and phone like the example [login to view URL] (information demo) right side.

We have a total of 11 maximum questions. A few similar questions as seen on: [login to view URL] ** Will provide the remaining questions to the coder qualified. See example.


Hey stranger, we are dying to get to know you better!

1. What is your name


2. Hello ____

What can we help you with? Select all that apply:

1. Option one

2. Two

3. Three

4. Four

html5, jquery, css3, mobile friendly a must.

Ferdigheter: CSS3, HTML5, jQuery / Prototype

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Om arbeidsgiveren:
( 78 omtaler ) West Fargo, United States

Prosjekt-ID: #16233562

Tildelt til:


I like lobster. I read the description, checked the links-all perfectly straightforward stuff. here is a demo of a simple angular form i did once [login to view URL] I get the slick design of the lobster Mer

$111 USD på 3 dager
(7 omtaler)

7 frilansere byr i snitt $133 for denne jobben


hello sir, I will create it as you need.I read all [login to view URL] will be compatible to mobile. I check your reference form. I am sure I can do that. I am strong in my field html5.css3.bootstrap.js. I am waiting fo Mer

$100 USD på 3 dager
(20 Omtaler)

Hi! I read your project description. we are ready to assist you day and night, 24/7. we have diversity of skills with lot of experiences in PHP, C Programming, CSS, HTML, Wordpress, Graphic Design, Web Design, Respon Mer

$150 USD på 3 dager
(5 Omtaler)

Hi AM READY TO START NOW. I read through the job details carefully and I am absolutely sure that we can do the project very well. I do have 8 years experience in the field of web designing and development and have Mer

$161 USD på 3 dager
(1 anmeldelse)

Hi, I went through your requirement and feel comfortable to do this job. I have good experience in website design & development. Please initiate chat to discuss further.

$155 USD på 3 dager
(3 Omtaler)
$155 USD på 3 dager
(1 anmeldelse)

Hello, I am very much interested on your project.I feel that I am the exact match for your requirements after thoroughly reviewing the job description and desired skills. Thanks

$100 USD på 3 dager
(0 Omtaler)