Fix Forms for a PHP/MySQL website

I need a few forms fixed on my website. It is a basic site. The backend I built myself and only has a few pages. I need the following done on the site. The database is already set up for what is needed. 1. [login to view URL] – The Location dropdown is not showing up properly based on the values in the database. The image field is blank. I would like to be able to edit the image. 2. [login to view URL] – The checkboxes on the [login to view URL] page are not submitting the correct values to the database. I have it so it should submit a 0 or 1 for true or false. I also need an edit page for these - brands_edit.php. 3. I need a modal box that pops up on the front end pages (you can just do one page and I can add to all the other pages) when someone comes to the site. It has a box in it to submit their email and then they receive an email with coupons in it. If they click the x to close it and go to another page it will not come back up. Then I need it on the footer so if they close the box but then decide they want to receive the coupons and be added to subscription they can.