Create a order form - more detailed information

I am looking for a freelancer who can program the following order form for a "one-product-website": All information shall be saved inside a database: - Each order shall get an order number - Some textboxes - Voucher-textbox: Depending on the voucher code, the price shall be either reduced or set to zero. The shall be some settings possible whether a voucher can be used several. If not, the user shall get a message if code is already used. There shall be a function to import new voucher codes. - Textarea (number of lines AND letters shall be limited) - 2 Checkboxes (I accept the terms of use and other one) - Dropdown to select way of payment (Bank transfer or paypal) IF paypal is chosen: Connect to the paypal account and make immediate payment possible. The information that the article is paid, shall be then saved in the database Depending on the way of payment, two different mail texts shall be send to the customer. IF Bank transfer is chosen: There shall be a bulk function to important the order numbers paid via bank transfer. The information shall be than saved in the same field of database (see Paypal Payment) As the order form shall be integrated via Iframe to current website, I am looking for a white background, but with graphically appealing order form. Draft of oder form with fields required Bestellung Daten des Bestellers Anrede Frau / Mann Vorname Nachname Straße / Hausnummer PLZ / Ort E-Mail-Adresse: Daten des Empfängers vom Brief Vorname Nachname Straße / Hausnummer PLZ / Ort Text für die Karte: {textarea – maximum 7 lines and width of 8cm of the textarea – if the end of a line is reached, then the word that is to be written will appear in the next line) Gutscheincode: textbox Button: „Gutschein einlösen“ By clicking on the button, the system checks the voucher. There is a bulk import function of voucher codes in the admin that can be used for just one offer. Furthermore, also „normal vouchers“ can be manually created in the admin that can be used several times. If the voucher is valid, the price of the article shall be reduced by the value of the voucher (also put in via admin) Zahlungsmethode: Dropdown-Field: Paypal / Überweisung There shall be the option in the admin to deactivate paypal payments. Checkboxes: […] Ich habe die Allgemeinen Geschäftsbedingungen gelesen und verstanden. […] Text 2 Both checkboxes needs to be activated before an order can be submitted. Zusammenfassung: 1x Kauf Karte, inkl. Versand Price Price is calculated by amount of good minus potential voucher value. Original price can be therefore set via admin. Button: Jetzt kostenpflichtig bestellen (1) Direction after clicking the button In case the user chooses „Paypal“, the user shall be directed to the Paypal Payment form. Once the payment is done, the order number shall be marked as „bezahlt“ in the database. If Bank transfer is chosen, the user gets a confirmation page of the bought with a text put inside the admin. If the user has chosen „Bank transfer“, I need to have the opportunity in the admin to have a bulk update of order numbers. (Textfield, in which can be put in several order numbers in the same time – each line one order number. By clicking a button „update“, also these order numbers shall be displayed as „bezahlt“ in the database.) (2) E-Mail after clicking the button Depending on the way of payment, the user gets a mail. The 2 mail texts shall be put in via admin. It is important, that there is the possibility to use information of the order form inside the mail-text, e.g. Dear [vorname] [nachname], thanks for your order. Your order number is: [order number]