Form to Dbase mysql

Job ID: 39226021

Budget: $30 – $250 USD

I want a form where i can put info.
Name, mail, company, adress, zip, city, categoryid, category, phonenumber.

I want category to choose from a table.
As admin i want to open the data and set the field ”aktive” yes or No, standard is No.

I want to use Wp, code via Snippet?
Related categories: PHP SQL WordPress Software Architecture MySQL