Add form to PHP site

We have a Zen Cart shop. We need a temporary web form added while we debug the site. We'd like to change the checkout page so that when customers press the checkout button it goes to our new form which will be secured with SSL. You will need to make sure that the whole contents of what is in the cart is also transfered to the new form. Customers will add their (1) credit card details and (2) delivery address (3) delivery option and (4) comments to this form. When the customer presses the button "Order now" the form contnts (including the cart contents information) are added securely to a separate database file that you will make accessible securely. Your code will be in the form of an include file to divert the button and a [login to view URL] file and an [login to view URL] in a directory specially created for this project. You will need to test/demonstrate on your own Zen Cart installation first ## Deliverables Once submitted the user will be returned to the site. Here is the example of the form in place. You need to simply create the form part with exactly the layout shown without the using the surrounding text (we will embed it into a template page). There may be small changes in text and possibly radio buttons.