Automate website sign-up

I currently have a website and a sign-up sheet for new hosting. However, this is one they print out and fax to me. I want this automated, so they can fill it out online and then click SUBMIT, they will be taken to an agreement page, click I ACCEPT and then be sent to my shopping cart for payment. The shopping cart is already done, no work on this is needed. When the form is submitted, it must be emailed to my email address along with the date/time/IP of the user. I will pay a BONUS if this can be done TONIGHT. All you need to do is automate my existing page, create the link to the agreement page, and then link that to my shopping cart. I have Matt's [login to view URL] available. ## Deliverables Once I accpet your bid I will give you the website.