Website form that can create a user on my on-line backup server via api/php

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Nkonye O.Sandy R.Nathan B.Mat W.WIT E. + 2 others have already sent a proposal.
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Experience Level: Expert
I have a online backup service software.

I am looking for help with a signup form that i can put on my website that will capture the user inforamtion (example in the image attached) and auto create a backup user via API on to my backup server and also I would like email address and other details in the form. I am not too interested in having payment method as of yet I can work on that later ( i will contact the client after the trial period via email). i would like something in php that i can integrate with my existing site. is anyone interested in doing this? If so how much would it cost?

Please check out this link

this is the guideand all necessary api instructions to create a api for the online backup (page 69)

so if you know how to make a api call in php please let me know. good project for someone's portfolio.

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