Wanted :: A customer contact form for my site

[movingconcierge]

[edit]I have uploaded two pictures to illustrate the form I'd like.[/edit]

I want an estimate request form for my site that works like the one on 1 2 3 movers dotCom.

I need it designed, coded, and installed on a linux server. It needs to be spam proof too.

Please review both sites BEFORE PM'ing me with your quote.

I will pay via paypal.

 

[WPGeek]

interested if this position still available, you mean prevention from spam bots, like turing number integration?

 

[EBORG9]

Same here.
My ICQ is: 431-802-387
See sig for company info, and full contact.
Thanks