Need a simple form connected with database

Job ID: 32325947

Budget: ₹600 – ₹1,500 INR

I need a simple form that will be connected to my database and we will show the details which we entered in the database will be displayed in proper order

Values that we will be capturing via the form is :
Name
Email ID
Company Name
Address
Domain Name
Domain Registration date
Date of Enquiry in company
Accepted terms & Conditions or not

Just 1 Hour work
Related categories: PHP Website Design MySQL HTML Database Programming