Basic Site Template, Web Form, & Database System

We need to create a simple web page template and form that collects and databases form responses. See this example of what we are going for: [login to view URL] 1. The html template can be similar. We want simplicity and a clean look. Leave blank space at the top header section of the template for a logo and text on a white background. You can employ a similar background and border. It is important that you be able to create a nice clean design template. We do not want a page that looks like the year 1995. The form layout must be appealing and user-friendly. Again, reference example. Utilize an attractive web 2.0 button for the submit action. 2. We require the same exact data fields and options as what you see in the example above. Form action should handle appropriate required fields and error messaging similar to the example. 3. Responses should be put into a mysql database. 4. Admin section with the ability filter and download database entries. Ability to export by date range. Each new form entry should also be sent via email to an email or emails that we can specify in the admin area. 5. Ability for form data to be passed through to a second database submit on page 2. (future need) Looking to start right away. Please ask any questions. ## Deliverables 1. Fully functioning web pages and form installed on our server 2. Functioning database on our server 3. Admin section to download and filter database results. ## Platform hosted on standard linux webhost with cpanel access