Form Email Data and Print

[phil2564]

I need a form to do the following Collect this data and one button to print and email it. This is the easy part.

 

Company Name (text box)

Name (text box)

Address (text box)

city (text box)

state (text box)

Zipcode(text box)

Phone (text box)

Email (text box)

Special Instructions (text area)

 

THE HARD PART OF THE SCRIPT, I need a button under the above data fields that when clicked it adds a

(SELECT MENU WITH 2 OPTIONS Small and Large)

and 2 (Text Boxes)

1 named blade#

and the other named amount.

 

Then underneath that another button that does the same thing but only displays a select menu with 2 options

1 options is (Beauty Shears or Similar)

2nd option is (Pet Grooming Scissors or Similar)

and a Text Box thats named quanity.

 

The user can keep adding either one of those by pressing the coresponding button.

 

I hope I explained this correct.

 

(TEXT BOX)