Need a form that connects to Paypal

Need a form that connects to Paypal

Cancelled

Job Description

We have a website that needs to collect following fields and then immediately send user to Paypal screen to checkout with credit card.

First Name
Last Name
Phone Number
Email Address
Street Address
City
State (dropdown menu)
Zip Code
What are you going to do with your ordination? (message box)
I agree to Oath of Ordination (checkbox)

We want all these fields saved into a database, we want an email sent to administrator, and we want a thank you email sent to user after payment.

We need to have this completed with 48 hours and uploaded on our website asap the website form we need to update is located on www.ordained-ministers.com

This is a fixed price job and if you have no work history on Odesk please do not apply as you will not be considered.