Web Credit Application Form

Attached you will find an html file that contains a credit application form. What we are looking for is a cleaner feel/look with the following criteria: 1. Form field names can NOT be changed. 2. When 'Join Application' is NOT checked all of the appropriate descriptions will be greyed out and the fields will be disabled (using javascript, php, etc). 3. The page will eventually be a php file but we are open to other suggestions for alternative javascript for the php code already in place. 4. Appropriate masks and validation for form fields. 5. Would like to receive a variable from prior web page to automatically fill in the 'Type' field. Samples of work done would be appreciated. All code should be well documented. ## Deliverables 1) Complete and fully-functional working program(s) in executable form as well as complete source code of all work done. 2) Installation package that will install the software (in ready-to-run condition) on the platform(s) specified in this bid request. 3) Exclusive and complete copyrights to all work purchased. (No GPL, 3rd party components, etc. unless all copyright ramifications are explained AND AGREED TO by the buyer on the site). ## Platform Unix/Linux web server. HTML/PHP