Custom Registration Form in WordPress
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Top rated PHP Web Development | WordPress | Magento | Drupal | OpenCart | PrestaShop | Joomla
Leicester
★ WordPress Developer ★ Magento2 Developer ★ Opencart Developer ★ Prestashop Developer ★ Shopify Developer ★ Ecommerce Developer
Islamabad
PHP/Wordpress/Python/React/Flutter - Web Development,Mobile Development,Data Science
Bay Minette
PPH's Top Web Designer, Developer with Great reviews & communication specialized in WordPress | Shopify | Graphics designer - Label/Packaging/UI/UX | Web app/Software developer | mobile app developer
London
Certified Laravel Developer | PHP | VueJS | Wordpress | API | Logo | Responsive Design | Shopify
Karachi
PPH #1 Service Provider in Development & IT : Wordpress|Magento|React Native|Mobile App Development|Angular|Node.js
Mohali
653791050754785582696248630836506139260836128342101190
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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