Freelancer

Description

I already have a flash template.
There is one link on the flash page (BUY PIXELS)
When a user clicks on the same..

This form should appear..

Outside India India (adverter chooses)
Blog/Forum Corporate website (adverter chooses)
*IF THE DATA PROVIDED IS FOUND TO BE INCORRECT, THE SLOT WOULD BE GIVEN TO ANOTHER ADVERTISER AND THE AMOUNT SHALL NOT BE REFUNDED

Segment (Drop down menu all 10 segments) - this will be the categories which i wud be giving later.

Size (Drop down - 2000, 4000, 6000 & 8,000) - this will give the advertisers the option to select where they want to place their ads i.e. on a 2000 pixel or so on...

Amt (will be calculated accordingly - say for eg - if the advertiser selects Outside India and Blog then the amt is $30, I wud give u the sheet which gives all the details about pricing)

Slot no - (1 to 250 or whatever no of pixel buttons on the page)
Pref no 1 ___
Pref no 2 ___
*If the slot is already booked, the decision to select the slot would be taken by www.xxxxxx.com(our site) on behalf of the advertiser

Link to the site ___________- Advertisers link
Text to appear in the slot - _______________ (say for eg - www.ithinksoft.com)
Description about the blog ( 300 characters)
Email id ______________
Accept terms and conditions.. (Ill send the terms and conditions later)
Credit card details
Cheque no: (In case of an Indian citizen)..

For the page where milliondollarhomepage kinda script wud be there - the page would be divided into 4 layers - Red, Blue, Yellow & Green (2000,4000,6000 & 8000 pixel buttons)