Urgent - Need a small Pop-up

Closed - This job posting has been filled.

Job Description

Check this site, you will see a Pop-up window - "Enter to win our *****" -


I need a same Window in this site


But I need 3 fields First name , Last name , Email. All these information that users enter need to be save somewhere. You can suggest me where to save these information.

This is a simple work so low bid will be given high priority

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