Backend for payment page

I'm building a website and need a form developed. No graphics, just code. Form is for payment. User fills in product data details, then clicks either "pay with paypal" or "pay with credit card". User gets sent to 3rd party payment page, and the from with product data details gets sent to my email. Then user is sent back to a "thank you" page. Don't think I need/want a DB for this. Looking for the fastest/cheapest way to get this done. Do not have a large budget for this. This will need to be done over the next few days. Thanks.