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Herofeeder

The "Contact list"

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hi guys sorry to bother you im quite new to web design and all

i need to make this for my exam and send it asap so i can get the diploma

 

http://imgur.com/a/PJ8y7

 

 

the first image on that link is what i did

 

 

the second is what its suposed to look like

 

its a "contact list"

where its asking me for my First Last name
my adress

email

and a description of what i want when i order it from this "Homework site" that i made

it also on the bottom has

Cancel and Send .

 

i literally have no idea what to write in code to make this can anybody help .

 

 

thank you in advance

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Do you really deserve the diploma if you don't have the skills to obtain it?

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i had to change jobs this was a last min mistake , last time i did web design i was 3 months ago but certain things happend in my family that forced me to get a 10 hour a day job.

i plan to continue learning with private lessons but right now i have to focus on earning money or that isnt possible
this is the only mistake i made in the " web " but sadly i forgot most of it and im struggling right now to even fix this problem while working as a waiter

if anyone can just help with this id be very grateful

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actually never mind , i managed to find a solution to this problem, my friend told my i needed php to make this ,so it kind of scared me , i found the solution in my old work

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