Build Multistep form HTML, JQUERY, PHP

Job ID: 33499988

Budget: $10 – $30 USD

Using HTML5, JQUERY, PHP

build a form that works as listed below.

Deliverables:
extimate.html
estimate.js (jquery script)
processESTIMATE.php

FORMDATA
-----------------------------------------------------------------
* = Required
will be ordered like: Labelfor, Field Name, TYPE


Form title: Patrol Estimate Form

Step 1:
Title: Contact Info
Fields:
* Company Name, conameFLD, TEXT
* Company Address, coaddrFLD, TEXT
* Company City, cocityFLD, TEXT
* Company State, costateFLD, TEXT
* Contact Name, contNAMFLD, TEXT
* Contact Phone, contPHNFLD, NUMBER
Contact Extension, contPEXTFLD, NUMBER
* Contact Email, contEmailFLD, CHECKBOX (0=NO,1=YES)
* Contact Phone, contPhoneFLD, CHECKBOX (0=NO,1=YES)
* Contact Morning, contMornFLD, CHECKBOX (0=NO,1=YES)
* Contact Afternoon, contAftFLD, CHECKBOX (0=NO,1=YES)
* Contact Evening, contEveFLD, CHECKBOX (0=NO,1=YES)

Step 2:
Title: Property Info
Fields:
* Property Address, propAdrFLD, TEXT
* Type of Property, propTYPEFLD, Multi-SELECT(Laundry, Gas Station, Commercial Property, Offices, Manufacturing, Mall, Other)
Parking Lots, plotNUM, NUMBER
Exterior Doors, extDrsNUM, NUMBER
Overhead Doors, OHdrsNUM, NUMBER
Walk Around Time, wlkARDTME, NUMBER
Floors, infFLNUM, NUMBER
Stairwells, stairNUM, NUMBER
Elevators, elevatorNUM, NUMBER
Average Doors Per Floor, avgdrNUM, NUMBER

Step 3:
Title: Concerns
Fields:
Concerns, concernFLD, TEXTAREA

Step 4:
Title: Areas of Interest
Fields:
Verification Patrol, vfcpCHK, Checkbox (1=checked, 0=unchecked)
Parking lot Patrol, prklpCHK, Checkbox (1=checked, 0=unchecked)
Exterior Patrol, extCHK, Checkbox (1=checked, 0=unchecked)
Interior Patrol, intCHK, Checkbox (1=checked, 0=unchecked)

Step 5a: (if Verification Patrol checked in step 4, then this is posted)
Title: Verification Patrol Details
Fields:
4pm - 7pm, vpANUM, NUMBER
7pm - 10pm, vpBNUM, NUMBER
10pm - 12am, vpCNUM, NUMBER
12am - 3am, vpDNUM, NUMBER
3am - 6am, vpENUM, NUMBER

Step 5b: (if Parking Lot Patrol checked in step 4 && Verification Patrol not checked, then this is posted)
Title: Parking Lot Patrol Details
Fields:
4pm - 7pm, plANUM, NUMBER
7pm - 10pm, plBNUM, NUMBER
10pm - 12am, plCNUM, NUMBER
12am - 3am, plDNUM, NUMBER
3am - 6am, plENUM, NUMBER

Step 5c: (if Exterior Patrol checked in step 4 && Verification Patrol not checked, then this is posted)
Title: Exterior Patrol Details
Fields:
4pm - 7pm, extANUM, NUMBER
7pm - 10pm, extBNUM, NUMBER
10pm - 12am, extCNUM, NUMBER
12am - 3am, extDNUM, NUMBER
3am - 6am, extENUM, NUMBER

Step 5d: (if Interior Patrol checked in step 4 && Verification Patrol not checked, then this is posted)
Title: Parking Lot Patrol Details
Fields:
4pm - 7pm, intANUM, NUMBER
7pm - 10pm, intBNUM, NUMBER
10pm - 12am, intCNUM, NUMBER
12am - 3am, intDNUM, NUMBER
3am - 6am, intENUM, NUMBER

Step 6:
Title: Addon Items
Fields:
Scantag tour Exterior, scantagEXT, NUMBER (Default=0, maximum of total of step 5C)
Exterior Scan Checkpoints, scanptsEXT, NUMBER (Default=0)
Door Tags, doortagsEXT, NUMBER (Default=0)
Scantag tour Interior, scantagINT, NUMBER (Default=0, maximum of total of step 5D)
Interior Scan Checkpoints, scanptsINT, NUMBER (Default=0)

Step 7:
Title: Finish Up
Fields:
* Agree, agreeCHK, CHECKBOX (Default=0)

Step THANKYOU:
processes the inputs, and displays the message: "Thank you for your interest, you will get a response as soon as it has been reviewed"
generates the sql statement to put into table and displays on the thankyou page
Related categories: PHP JavaScript HTML5 jQuery / Prototype