Russian Insurance Form

Hi there, I have checked your project brief very carefully and can develop this web form with necessary backend. Data will be saved in database. I have several years of experience designing and developing website and already developed many custom websites. Look forward to hear from you & start further discussion through project message board. Regards Khorshed RS Software

Hi. Will be glad to help with Insurance Form recreation. Have great experience with HTML. Can You send more details to understand whole scope of work?

Hi there! Did go through your Job Description and glad to share that I have experience in working with PHP and Mysql platform. I have more than five years of industry experience and have been the part of diverse industry verticals. I also have expertise with Magento,WordPress, PHP, PHP Scripting and CodeIgnitor along with Photoshop. So can help you with the design as well. Looking forward to your response.

Respected Sir/Madam, Will it be password protected form? Do you have hosting? if so, can u tell where will it be deployed? Will it be exact same design or you want some changes? Kind Regards, Pankaj Garg Profile Page: https://www.freelancer.com/u/WebInfoSolutions UserName: WebInfoSolutions

Hello there? I'm Muhammad, a Designer, and Full Stack Developer, working as FRONTEND and BACKEND expert, with over 10 years of industry experience. I have a diversity of skills in; Web Design, PHP, MySql, HTML, CSS, Bootstrap, JavaScript, jQuery, Word Press, Shopify, Responsive sites, e-commerce, CRM, CodeIgniter, Laravel, Magento, and Joomla. This is quite the simple job for me. I think have the skills to do a great job. I can strongly assure you. I am the best match for your job. I won't disappoint you if you will give me a chance to work with you, as a matter of fact, all my previous work has received 100% customer satisfaction. Thank you for taking the time to read my application. Please click chat button for more discussion! Best wishes

Hello, I can make this form for you within about of 3 days after start. Writing in English because it shows flag of USA in your profile, so I don't know if you speak Russian or just posted the doc in Russian. Но русский - мой родной язык. So, if interested, just contact me by chat and we will discuss everything. Thanks

Dear client I have good skills about php and laravel and nodejs If u want me ,I will show good result for u I have good review for u I have rich experience about your job I m very interesting of your job My review is very good for your project fore more detail,please contact with me I m ready on your job yet after I study I can start soon I m fullstack developer and senior developer thanks to my proposal

Hello, I can create the online form of attached PDF form. When form is filled data will be saved to database.

Hello, my name is Andrey, and I am from Russia, but live in Montenegro now. I have over 10 years experience with PHP/SQL and over 8 years experience with Delphi/BDS. List of my featured projects (with description) can be seen in "Portfolio" section at this site: http://www.freelancer.com/u/RedOctober.html?page=portfolio I can help you with your Insurance Form, I think (especially, it's Russian :) ). But could you please give me more info about a task - in this case I can adjust my bid accordingly. For example, do you need a frontend form looks exactly like a printable form you've attached? Also you need to save a form results in database, as far as I understand. Do you need this database structure already, or need to create? Anyway, we can fruitfully cooperate - maybe my bid a little more than others, on the other hand, I can provide European quality of my work for you, based on the experiences of my previous projects. I hope you make the right choice. --- Thanks and regards, Andrey A. Seregin.

HI I have seen the form and we can create it in html and it will be further saved to database when its filled and submitted. We want you to initiate chat so we can discuss further and finalize it accordingly. Thanks Josh Davis.

Hi, I'm sure I could help you. I've done many web forms in HTML, css and Javascript. Of course I know MySQL Lets talk over chat details. Regards from Mexico

Hi, please let me know if you want the have same look as the one in PDF. Also will need to know which fields and in what way should be validated + if you need some kind of admin to check data from database. Best regards

I can do your task and have checked the pdf also. In the bid amount, I shall provide website, Android and IOS applications . Waiting for your message........

Hello Write me please, I can do such form Thanks ################################## ##################################

Hi Let's discuss more. I have done that kind of job.

Hi there, I have plenty of professional experience developing web applications and forms that interact with database backends. Is this form going to be on existing site with a backend database or do you need one set up for you? I'd be happy to chat a little bit more about what your needs are and so we can find the perfect solution for you.