Lead Form Jun 12, 2009
I am looking for someone to program a PHP/AJAX/JS lead form for me. I need it pretty specific and be able to output into a CSV file and also have the choice to email the output real time (so I want to be able to have the choice for it to output the fields into a CSV file or change it so I can have it output into an email and email it to an email address of my choice with the filled out fields shown).
What I need is the user to enter a zip code – then it would take them (preferably via AJAX so there’s no screen refresh) to another part of the form where it displays the CITY and STATE for the zip code they entered – and then it will show contact information fields (name, address, phone, email, “type of project you’re interested in”, etc.) and then it will say Thanks for your submission – A local contractor in (whatever city and state for the zip code they entered in) will be calling you within 24-48 hours, etc… You need to have or find a database to use that will have all the zip codes match the city and state (I don’t have this)
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