Request App Project

First Name
[dynamic_text* FirstName]

Last Name
[dynamic_text* LastName]

Email
[dynamic_email* Email]

Phone Number
[dynamic_tel* PhoneNumber]

Status
[dynamic_select* Status include_blank "Individual" "Company"]

[group Company] Company Name
[dynamic_text* CompanyName] [/group]

[group NoofEmployees] No of Employees
[dynamic_select* NoofEmployees include_blank "Less than 10" "10-20" "30-50" "50-100" "Above 100"][/group]

[group CompanyAddress] Company Address
[dynamic_text* CompanyAddress] [/group]

[group Address] Address
[dynamic_text* Address][/group]

City
[dynamic_text* City]

Country
--Choose your country--AfghanistanAlbaniaAlgeriaAndorraAngolaAntigua & DepsArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBhutanBoliviaBosnia HerzegovinaBotswanaBrazilBruneiBulgariaBurkinaBurundiCambodiaCameroonCanadaCape VerdeCentral African RepChadChileChinaColombiaComorosCongoCongo {Democratic Rep}Costa RicaCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFijiFinlandFranceGabonGambiaGeorgiaGermanyGhanaGreeceGrenadaGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHungaryIcelandIndiaIndonesiaIranIraqIreland {Republic}IsraelItalyIvory CoastJamaicaJapanJordanKazakhstanKenyaKiribatiKorea NorthKorea SouthKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmar, {Burma}NamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorwayOmanPakistanPalauPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalQatarRomaniaRussian FederationRwandaSt Kitts & NevisSt LuciaSaint Vincent & the GrenadinesSamoaSan MarinoSao Tome & PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth SudanSpainSri LankaSudanSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad & TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamYemenZambiaZimbabwe

[group State] State [dynamic_select* State include_blank "Abuja (FCT)" "Abia" "Adamawa" "Akwa Ibom" "Anambra" "Bauchi" "Bayelsa" "Benue" "Borno" "Cross River" "Delta" "Ebonyi" "Edo" "Ekiti" "Enugu" "Gombe" "Imo" "Jigawa" "Kaduna" "Kano" "Katsina" "Kebbi" "Kogi" "Kwara" "Lagos" "Nassarawa" "Niger" "Ogun" "Ondo" "Osun" "Oyo" "Plateau" "Rivers" "Sokoto" "Taraba" "Yobe" "Zamfara"][/group]

Type of Service [dynamic_select* TypeofService placeholder:Choose%20type%20of%20service%20 "Web Development " "App Development " "Web & App Development"]

[group WebDevelopment] Web Development [dynamic_select* WebDevelopment include_blank "Web Development" "Mobile Web design" "Web & Mobile Development" "Cyber Security" "Ecommerce Solutions" "Coding & Development" "Real Time Monitoring" "Digital Marketing" "Website Redesign" "Social" "Brand Development" ][/group]

[group AppDevelopment] App Development [dynamic_select* AppDevelopment include_blank "Web Application" "Mobile Application" "Utility" "Games" "Productivity" "Lifestyle"][/group]

Budget [dynamic_select* Budget placeholder:Choose%20your%20budget%20 "$10000 - $20000" "$30000 - $60000" "$100000 - $200000" "$300000 - $500000" "$600000 - $1000000" "Above $1000000"]

Subject

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[dynamic_submit "Submit"]

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