Simple Printable Form

We are an online seller of novelties, pranks and gags. 99% of our orders are via Credit Card. However, we recieve e-mails daily asking to pay via the mail with check, money order or cash. So I need a simple page that someone can print out (prefer one of those little print buttons on the page to make it easier). The page must look professional have our logo, our address, a typical order form look for the person to write in the items they want, the quantity and the price. It must also have them enter the shipping amount with a note that Under $ 25.00 is $ 1.99 and over $ 25.00 is $ 4.49. A box for sales tax with it noted CT Residents Must ad 6% Sales Tax, and a place for them to total the order. Nothing too fancy, just a nice HTML page that opens in a seperate window without all the toolbars and stuff with a form for the customer to fill out. Really would like the print button on the page if possible. ## Deliverables Complete and fully-functional working program(s) in executable form as well as complete source code of all work done. Complete copyrights to all work purchased. ## Deadline information Soon!