Project Detail

Description

I have a coupon survey/coupon project that needs to be completed within 1-2 weeks. Most of it will remain static so there should be minimal coding.

Here is the rundown:

I have attached the survey questions that will be used for customers that i would like to look similar to this layout
http://bettymills.wufoo.com/forms/silicon-valley-hungry-minds-food-survey/


The form must be able to track IP or email addresses. I want to restrict either the IP or email address from filling out the form more than once a month.

After each person fills out the survey I want to have the name and email collected into a CSV:
First Name,Last Name,E-mail Address

Once someone fills out the survey, I want them to be delivered to a page to print a coupon. The coupon will be an image 900px wide x 658px long. I also want the page/script to embed a date onto the image 10 days from the date the form was filled out.


EXAMPLE: If I fill out the form on December 1, 2007 the page should pull up the image of the coupon that says Expiration Date: December 11, 2007.

Cheers,

Adam


Additional files submitted:
SP Customer Survey.doc