100.00 Paypal to anyone who can figure this out..

Hi I just had a question answered for an issue I have been having but now I have another question that has come from the previous one. Have a look at the pictures provided in the site and the actual form for which they originated from. Basically the pictures show how I would like the form to function once someone has input info and clicked submit. Thank you in advance for your help.

**By the way, the results dont need to completely match but basically just want things to be grammatically correct.

This is the link… I am using my churches ftp to host this test file so you can easily access everything.


The attached HTML was thrown together real quickly so please excuse the mess. I have comments in spots I need help with. The pictures indicate how I would like the form to function but I have no clue how to work this. I am a student and want to make an interactive project. I am taking web design class but its only an HTML class and they dont even offer PHP so I want to really dive in and go beyond. I have been trying to learn PHP here and there online but I cant find anything to help me with what I want to do. If you can solve this I will send you 100.00 instantly. 100.00 will save me from having to get hair implants as I keep pulling my hair out to find a fix for this.

By the way if I dont reply right away its not because I blew you off and didnt pay you, I have to go to class later… Just private message me your paypal email and I will send it to you as soon as I get done.

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