I need a contact form with the following fields:
Name (Required)
Email Address (Required)
Phone Number (optional)
Message box (where they type their message- Required)
How they found our site (pulldown list-which I can populate later)
The trick is that I want a Pull Down Menu called Type or Direct to: and the choices will Consist of Sales (which if selected should go to sales at [login to view URL]), Rentals (which if selected should go to rentals at [login to view URL]) and General Information (which if selected should go to info at [login to view URL]).
Form should also have a confirmation screen in which it ask users if the data they submited is correct and then gives them the option to send the email or change the data.
If they send the email, it should go to a page with a short message (which I can write later) and if they decide to change the data it should go back to the original form with thier data in it so they can change it.
Should use aspmail. Complete script should be placed and formated to fit the template of our site and ready for us to make active once tested.
Thats it!
## Deliverables
1) Complete and fully-functional working program(s) in executable form as well as complete source code of all work done.
2) Deliverables must be in ready-to-run condition, as follows (depending on the nature of the deliverables):
a) For web sites or other server-side deliverables intended to only ever exist in one place in the Buyer's environment--Deliverables must be installed by the Seller in ready-to-run condition in the Buyer's environment.
b) For all others including desktop software or software the buyer intends to distribute: A software installation package that will install the software in ready-to-run condition on the platform(s) specified in this bid request.
3) All deliverables will be considered "work made for hire" under U.S. Copyright law. Buyer will receive exclusive and complete copyrights to all work purchased. (No GPL, GNU, 3rd party components, etc. unless all copyright ramifications are explained AND AGREED TO by the buyer on the site per the coder's Seller Legal Agreement).
## Platform
windows server