Simple PHP data collection website that emails results. Build a 3 page website (design provided) that will collect email address, name phone, and send user an email as well as email website owner. More complete description of function here (also see PDF diagram explaining layout, flow of info, and included logo image): Magnetad webpage: Page 1- collects following information: 1) Coupon code (should check to verify code = 1 of 4 valid options- if not, return error message) 2) Email "Next" button submits email to database, triggers automatic email send, and takes user to page 2. Page 2 Populate name of Doctor based on coupon code entered on page 1 Populate value/type of certificate based on coupon code entered on page 1 Collect First Name Collect Last Name Collect Phone NUmber Use pulldown menu for month, pulldown for day to allow user to select preferred date. If no date selected, default to "date to be selected later" message in email/database. "Complete" button submits collected info, takes user to page 3 Page 3 Thank you page populates with coupon value Emailing: Each submission from page 1 should generate an email to the address submitted with the corresponding coupon information. It should not email if an incorrect coupon code was submitted. Each submission from page 1 should generate an email with all captured information to cc at [login to view URL] with subject line "magnetad entry". If a correct code and email are submitted but page 2 is not completed, only the page 1 info will be sent. If page 2 is completed, all info is sent in one email. Any questions, suggestions, improvements in info flow, design will be considered if they make website work the same or better.
## 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
Webpage design requires html, php and css if desired to build site with required functionality. Should work on ie, netscape, firefox including pc and mac versions.