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Simple paypal form required

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I need a html form that will pass back the following information from paypal to the admin email.

The customer will fill out the form inputting the following:

Last name:
Account Number:
Unit number:
Amount paid:

ALL info MUST be passed back via email after customer has paid, I don't care about IPN. Just want the form to work.

Example :
Last name: Smith
Account Number: 123456789
Unit number: 1234
Amount paid: $30

$20 is what I will pay for this.

Thanks

~Zig
 
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Bump....
 
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so the customer adds their own account number, unit number and the amount THEY pay?
what happens, if someone types in $0.01 for $30.00 item?

confused of what you want really. pm me

thanks
 
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pm sent
 
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If you are still looking, please PM me as well.
 
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Hi All, Form has been supplied and is working correctly.

This thread is now closed.
 
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