Build a data entry form

I need a "sign up" page for my website. I currently have my website down from its landing page. I need a page built that will allow customers to sign up for an account for my website, so when I have it back up and the modifications finished I can use the information they have entered, to create an account for the website when it is back up and operational.

The landing page will have my company name and logo, along with some other content that will be designed by you. It will also have an area where they can click to apply for an account and they will enter the required information.

I would like to sequence of information that the customer enters to slowly reel them in, not require all the information to be entered on the first page.

About my website: my website will be where pecan growers in the US can log on to sell there pecans to buyers around the world. Also it will be where buyers around the world can log on to buy pecans direct from growers. This is the audience that I am targeting, so please keep this in mind with design.

The information collection pages that you will create will need to collect the following information:

1. Grower / Producer

First name

Last name

email address

Farm (company) name

physical address

phone number

fax number (optional)

Cleaning plant address:

Varieties produced and amount of each, date available for sampling

2. Buyers

First name

Last name

email address

Company name

physical address

phone number

fax number (optional)

Delivery address

Types of pecans purchased, amounts of each, purchase dates

3. Accumulators

First name

Last name

email address

Company name

physical address

phone number

fax number (optional)

Delivery address:

Varieties purchased and amount of each,

The completed pages will be as follows: a very professional looking landing page that shows relevant information about the pecan market, (current prices, news, etc), an area where customers can log in, and apply for an account. The account application section will gently and non threateningly collect the requested information, about each type of account applicant. The information will then be stored so that I can later use the information to approve or disapprove customers for an account.

You will be responsible for uploading the pages to my website domain and showing me how to use and update the information such as the news and prices, as well as get the information of new applicants.


Matthew Bailey

Skills: Graphic Design, HTML, PHP, Website Design

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About the Employer:
( 1 review ) Camilla, United States

Project ID: #5792374

Awarded to:


i am ready to start work [login to view URL] This is my previous website what i did for a university so i have experince with these issues

$61 USD in 3 days
(2 Reviews)

12 freelancers are bidding on average $416 for this job


Hi, I am here to discuss more regarding your specification and need. We have sound knowledge in : * PSD to XHTML conversion. * PHP and mySql. * Joomla 3 Website design and customization. * Wordpres More

$515 USD in 12 days
(121 Reviews)

i have 8+ years of experience. Can we discuss the project. Please initiate a chat with me so that we can discuss the project at a broader level Please see my reviews Ce More

$1546 USD in 20 days
(18 Reviews)

I have gone through the requirement and quite sure that we can deliver the work, we have previously done a similar task...... Restaurant Online Order: [login to view URL] Blog Website: [login to view URL] More

$200 USD in 7 days
(133 Reviews)

Hello, Saw your job posting and your requirement seems perfect for me as per My skills. Here you can see my work portfolio with some samples of my work.. [login to view URL] I am fulltime freelance More

$1052 USD in 15 days
(9 Reviews)

hello sir ,have read your description and would like to present my proposal to you. I m expert in html5/css3 and along with php/mysql for server side. I can create the required Signup form for your site and can code More

$111 USD in 2 days
(49 Reviews)

Hello, Thank you for taking the time to review our bid! We're really EAGER to work on your project. We've studied your project details with the specifications & understood your requirement what you're looking for. We c More

$568 USD in 10 days
(68 Reviews)

I'll work on it. Please come on chat for further discussion, so that I can start the work right away. Features: 1. 2 months post delivery tech support free of cost. 2. My code will be W3C compliant, so it will help More

$147 USD in 3 days
(21 Reviews)

Dear Matthew Bailey Greetings, =>As per the Job Posted: [login to view URL] Up form will be design & develop along with My Account Option. [login to view URL] the Landing Page & Logo along with Content. [login to view URL] look & feel will be world c More

$200 USD in 7 days
(17 Reviews)

Hello sir,  I have seen your requirement of the project and can do the mentioned requirement with good efforts and 100% completion with good quality and on time completion. Website Implementation Done :  ------- More

$231 USD in 15 days
(11 Reviews)

Greetings. You have interesting project and I am ready to work on that right now. I have education and experience in web development more then ten years. Have a nice time and I hope to get answer from you.

$250 USD in 15 days
(6 Reviews)

[login to view URL] is my Skype id and i m ready to design and develop the registration page in your website as per your requirement and deliver it on time. .

$35 USD in 3 days
(9 Reviews)

Hi Buddy, This type of work already done by our team and we are skilled enough to take this project. Its nice to see your project as this is what exactly we are looking for.  This include testing as well. Becau More

$222 USD in 3 days
(0 Reviews)