Formularz kontaktowy oraz rejestracji

Closed job
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mrozaq
Employer
Job category:
Web pages
Expected budget:

Negotiable

Preferable skills:
Published:
Valid until:

Job description

Zlecę wykonanie do strony opartej o responsywny kod HTML5 oraz CSS3 prostego formularza kontaktowego oraz rejestracyjnego. Wygląd jak ten -> http://www.duport.co.uk/company-formation/contact.php

Formularz kontaktowy z polami:Imię, Nazwisko, Adres email, Nr telefonu, Wiadomość i przycisk wyslij

Formularz rejestracyjny wg poniższego schematu:

Owner’s Details:

Title:

First name;

Surname:

Address:

Number/Name:

Street:

Town

County:

Post Code:

Contact Phone Number:

Email:

Pet’s Details:

Name:

Species (cat; dog; rabbit etc.):

Breed (Labrador; British Blue etc.):

Colour:

Age:

Weight (if known):

Gender: Male: Female:

Neutered: Yes: No:

Date of last Vaccinatiuon:

Date of last Worming:

Microchip Number (if applicable):

Insurance Company (if applicable):

Do you have additional pets you wish to Register: Yes: No:

If “Yes” – please email their details to: xxx@yy.pl

Main Presenting Symptoms:

When did the symptoms start:

HOW DID YOU HEAR ABOUT ASHDEAN VETS:

Former Client Reccommendation:

Practice Signs:

Local Newspapers:

Local Village Magazines:

Internet Search Engine:

Reccommendation: