Need website form to collect data and place in MySql

I have a simple landing page online and would like for the form to:

Collect Name user enters

Collect Username and check that is available by indication.

Collect email address and check that it is not already resisted.

Add DOB and check check they are 18 or older.

Collect Ip address

collect timestamp

All goes into database with a simple back-end for me to manage and sort data.

Skills: MySQL, PHP, Software Architecture, Usability Testing, Website Testing

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About the Employer:
( 7 reviews ) Boulder, United States

Project ID: #11709031

Awarded to:


Hello/ Hello Sir, I have read your job description and understand your requirements. I have proper experience about many web design, html, CSS, ajax,Bootstrap,html5,CSS3, landing Page design, wordpress, Laravel,PHP More

$15 USD in 1 day
(6 Reviews)

18 freelancers are bidding on average $34 for this job


ZERO ERROR GUARANTEED!! Please read my 140+ reviews. Hi, I can do this for you quickly and with great quality for cheap...Based in Nepal we provide quality work, and 100% satisfaction guarantee..We are not satisfie More

$50 USD in 2 days
(58 Reviews)

Hello, Sir We are web & mobile development team of JinDongZhe freelancer We have powerful back-end(PHP, Java,Spring Framework, Hibernate, JPA, Oracle, Hadoop etc) and front-end(Android, iPhone, Hybrid App, Mobile we More

$54 USD in 1 day
(18 Reviews)

Hi, I am Gaurav panwar (PHP, MVC, WordPress GURU, Designing & eCommerce Expert). Check out my portfolio at [login to view URL] I have gone through your requirement, You need - * website form to collect data More

$100 USD in 4 days
(25 Reviews)

Hi,how are you? i visit site. i can do it. I have the expensive experience of 6+ years in developing web programming, and can carry out your any proposal in time completely. I understand your proposal enough,so I h More

$29 USD in 1 day
(6 Reviews)
$20 USD in 7 days
(1 Review)

Hi, I am an php and mysql developer having 10+ years of expereince. I can able to fix the form as per you requested. Please award this job to me. Thanks, Nawas.

$25 USD in 1 day
(5 Reviews)

Hi There, I can make your form function [login to view URL] will work as you stated. Looking forward to working on it soon. Regards, Yanis

$50 USD in 1 day
(6 Reviews)

Hello, Greetings, I am having more than 6 Years of experience in Development & Design, Can get the things done without any hassle for sure. Please do share the details of the project so that I can get it start More

$29 USD in 2 days
(6 Reviews)

Hi there, I am a professional Graphic Designer & website expert with 2+ years experience. I have read and understand your project Description. I can code and design using languages like PHP, HTML, CSS, Bootstrap to More

$50 USD in 1 day
(5 Reviews)

I can do ur [login to view URL] u need?

$10 USD in 0 days
(4 Reviews)

I’d like to be considered for your writing position. I am working on latest web technologies for more than 5 yrs. Always I tried to provide quality work which meet client's requirements. I am available for work now. Av More

$45 USD in 2 days
(2 Reviews)

hi I can do your work it's very easy I can do it with php & MySQL hope to hear from you

$10 USD in 1 day
(4 Reviews)

Hi, I read out your requirements and I am ready to work with you. I will create and save all user request in database and show these details in table format where you can filter the data by nane and enail or whatever y More

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$35 USD in 20 days
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m new in this freelance and have to make my own business so hope you understand. I will give you best support still to end :-)

$10 USD in 1 day
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$25 USD in 5 days
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Dear Sir/madam, Greetings. I have done many projects like this, i can do this as well. You can see the old projects like [login to view URL] [login to view URL] etc..

$35 USD in 1 day
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Hi, Greetings! -------------------------------------------------------- I have gone through your requirement and understand project requirement. We are software professionals and having expertise in Wordpres More

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