Form/Simple Database (MySQL)

I need a form page connecting to a MySQL database with html/php code and design. The database will need to contain the following fields: Name: OPTIONAL (database does not differentiate between first and last name) Location: (drop down boxes China, Hong Kong, Taiwan, Singapore, USA, Canada, Australia, Europe, Middle East, South America, Africa, Other Asia Email: Add a Friend: (When user decides to “add a friend?? another box with Name, Location, Email, and Add another Friend appears). The maximum amount of friends to be added before being submitted is 25. Name and Email fields need to have a reasonable character limit (30). When user tries to submit information without entering an Email address, or Location they are prompted to do so. Name is optional. I also want the database to record and file the date that each email was submitted along with the user information. When a user submits information, it should go to and be stored and organized into the database. After submitting the information the user should be sent to a page that thanks them. I will handle the content/html for this page. Just make sure you add that to the code so I can edit it by adding the proper .html file. The color and feel of the graphic part of the project should be like the image I included (rounded corners, drop shadow, gradient colour, light border, clean). I want a submit button made like the one the image, but the text needs to be editable. Please make this in an editable PhotoShop 6 format. Ultimately I want everything installed and working, and I want to be able to “copy and paste?? the form into a web page I will design. I am open to suggestions or ideas that might improve this project. PLEASE READ THE REST OF THE DESCRIPTION IN THE ATTACHED FILE. Good Luck, Jayader ## Deliverables 1) Complete and fully-functional working program(s) in executable form as well as complete source code of all work done. 2) Deliverables must be in ready-to-run condition, as follows (depending on the nature of the deliverables): a) For web sites or other server-side deliverables intended to only ever exist in one place in the Buyer's environment--Deliverables must be installed by the Seller in ready-to-run condition in the Buyer's environment. b) For all others including desktop software or software the buyer intends to distribute: A software installation package that will install the software in ready-to-run condition on the platform(s) specified in this bid request. 3) All deliverables will be considered "work made for hire" under U.S. Copyright law. Buyer will receive exclusive and complete copyrights to all work purchased. (No GPL, GNU, 3rd party components, etc. unless all copyright ramifications are explained AND AGREED TO by the buyer on the site per the coder's Seller Legal Agreement). ## Platform Not Required