Customized website checkout with one item purchase

We are a snowmobile club in upstate NY. We want allow purchase of a membership online with a custom checkout that includes all information in the single form that we have. So what we are looking for is to build a button which leads to an encrypted page. When they click the button, it goes to a page which has all our membership information that they must fill out in a form. Specific fields will be mandatory. Once they input this information, it needs to be linked to a database to allow the customers information to be stored. Once the form is filled out with necessary fields, the click a purchase button. The button then transfers all information into appropriate checkout fields. They chose payment option, credit/debit card or submit using Paypal. Upon completing the order we receive an email stating they have paid for membership and all the information in our form is transfered to us in the email. We currently host on [login to view URL] and have osCommerce installed. We need the custom checkout form, database and checkout process for credit/debit cards and Paypal. One custom form, one payment form, email confirmation including all info in the custom checkout form. ## Deliverables 1) Complete and fully-functional working program(s) in executable form as well as complete source code of all work done. 2) Deliverables must be in ready-to-run condition, as follows (depending on the nature of the deliverables): a) For web sites or other server-side deliverables intended to only ever exist in one place in the Buyer's environment--Deliverables must be installed by the Seller in ready-to-run condition in the Buyer's environment. b) For all others including desktop software or software the buyer intends to distribute: A software installation package that will install the software in ready-to-run condition on the platform(s) specified in this bid request. 3) All deliverables will be considered "work made for hire" under U.S. Copyright law. Buyer will receive exclusive and complete copyrights to all work purchased. (No GPL, GNU, 3rd party components, etc. unless all copyright ramifications are explained AND AGREED TO by the buyer on the site per the coder's Seller Legal Agreement). ## Platform needs to runs in both mozilla firefox and IE5 or better