We need help in google maps page modification required, PHP Web Programming

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We need help in Google Maps Page Modification Required

I want a modification to a Google Maps Page.

When the page returns the location address I need the user to be able to click on the location address and then to open a text box alert that prompts for the users name. The Alert must have buttons... name is required.

If is pressed then the address. Location coordinates as well as the name should be posted to our server using a WebService. (URL called with arguments).

Desired Skills are MySQL Administration, HTML, PHP


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