JAVASCRIPT: One Simple Form Needed

WE NEED HELP creating a single Form in Javascript. Can you help us? Our Nonprofit institution is trying to raise donations to save a historical mill. We offer various “thank you gifts” for various donations, and we are currently using PayPal to let them transfer funds to the cause. I need someone to help us write a Javascript form that will: 1.) allow donors to enter a donation amount or select from a drop down menu (if they selected a TShirt, they should be able to choose SM, MED, LG or XLG); 2.) Let donors provide contact info (name, address, City/State/Zip, phone, email) that gets emailed to my email account, so we know where to send their gift and how to contact them; and 3.) transfer their donation into our bank account by way of PayPal (unless someone knows a more elegant donation solution without transfer fees). The Donation page is at : [login to view URL] This is not a huge or complex project; we just need it done soon. Please contact me and let me know if you can help… THANK YOU!