Form that gets auto submitted to website when online

Job ID: 32489491

Budget: $10 – $30 USD

I am looking for a form created in wp / drupal or any other (javescript etc) thats connected to a simple website and get submitted on wifi connect.

Form will have fields like first name/phone/ticket number/email.

Need a solution with dummy form if anyone can provide.
Related categories: PHP JavaScript WordPress Drupal Clover