Credit Card form to send custom amount via First Data Global Gateway e4?

I have the following web form [login to view URL] (as an example) that i would like to get working to send funds to a First Data Global Gateway e4℠ account using their API Service. I am also hoping to have proper validation for the form fields. Hopefully the url provided above will be self explanatory as to what it is that I am looking for. Here is some info on First Data: First Data Website [login to view URL] I also have the gateway_id, password, and division_id for being able to communicate with the First Data API. If any developer has any questions please feel free to post them. I'll be more than happy to answer them.