ASAP! Get my form to transmit customer data to my CRM

I have a simple webpage already ready to go, and I have a form with several fields in place (name, address, phone, CC info, etc). I don't know how to get the form data to send to my CRM. My programmer is on leave and I need to get this done ASAP (probably would take the right person 15min to do). I have all the CRM info, the identifiers and IDs for the database, but I just don't know enough about how to get the customer's info sent to the CRM database. Here is the order page with the form: [login to view URL] If you are certain you can do this, I can get you the FTP info for the site, and whatever you need to connect the dots. Again, I need this done NOW! :)