Custom Registration Form in WordPress
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Post a project like this2151
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- Posted:
- Proposals: 21
- Remote
- #2017179
- Awarded
UK WordPress specialist with added marketing skills - a unique contractor with 25 years creative-design and coding experience.
Midlands
Web Developer | Bootstrap Expert | WordPress | PSD to HTML | HTML to WordPress | Php | Custom CMS | Woocommerce
Islamabad
53498510630902228810221740221677552059068190334817217521417097136422713266061165221
Description
Experience Level: Intermediate
We need a form where a user registers with:
1. Title
2. First name
3. Last Name
4. Date of Bith
5. Gender
6. Email Address
7. Password
8. Drop down on few things to choose from (We will provide you with this).
9. (TICKY PART) - User to start typing in the name of the hospital and while they are typing, the results should start appearing as a autocomplete. Hospital name, address and postcode will come from database file we have (CSV Format). So they can only select from our list. If the map can be shown, it will be a bonus (Optional).
10. From the autocomplete above, once they have clicked on the hospital they require, it should fill in the rest of the field i.e, hospital name, address and postcode.
11. 2 Yes or no checkbox
12. Drop down on few things to choose from (We will provide you with this).
13. Very important, a checkbox to agree to the terms and condition.
14. Thank you message.
15. A user account is only creation user we have certified the information from this above form.
This form is for data collection only.
For your ease we can provide you process from our competitor, we have a screenshot of the whole procedure. We can skype if needed.
1. Title
2. First name
3. Last Name
4. Date of Bith
5. Gender
6. Email Address
7. Password
8. Drop down on few things to choose from (We will provide you with this).
9. (TICKY PART) - User to start typing in the name of the hospital and while they are typing, the results should start appearing as a autocomplete. Hospital name, address and postcode will come from database file we have (CSV Format). So they can only select from our list. If the map can be shown, it will be a bonus (Optional).
10. From the autocomplete above, once they have clicked on the hospital they require, it should fill in the rest of the field i.e, hospital name, address and postcode.
11. 2 Yes or no checkbox
12. Drop down on few things to choose from (We will provide you with this).
13. Very important, a checkbox to agree to the terms and condition.
14. Thank you message.
15. A user account is only creation user we have certified the information from this above form.
This form is for data collection only.
For your ease we can provide you process from our competitor, we have a screenshot of the whole procedure. We can skype if needed.
Websolutions (London) Limited
100% (8)Projects Completed
9
Freelancers worked with
9
Projects awarded
56%
Last project
29 Apr 2021
United Kingdom
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