Create an Eligibility Form on our WordPress Website

I am looking to create an eligibility form on our existing website based on some questions that the applicant need to answer, if eligible they will be forwarded to a booking system (already in place) and if not they will be let know that they are not eligible to apply.

The eligibility is based on age and post code (a list of postcodes will be provided to match against the user's input).

We would like to see stats on the back end of the form at glance based on the answers provided (probably some widgets that could expand to show more details about the applicants).

Please get in touch to discuss in depth and pricing for the work. Looking to start asap.

Many thanks.