Create a form for an existing website

Hi, ? I am designing a website that sells 1 product. There is NO online transaction going on. We will do the credit card charge manually SO THIS IS NO ONLINE STORE. ? I want a form designed that will take take the information and save it on a secure server in an individual file every day. ? FILE SHOULD BE IN A? **.TXT**? FORMAT NAMED? **[login to view URL]** **Whereby xxxx identifies the fulfillment house(provided to the winning bidder) and MMDD is month & day** The format that I need it in is attached as? **[login to view URL]** ** ** It has the placement of the field and how many? ** ** But not all fields are required. See SampleOrderFile and you will see what is needed and not.? To sum it all up, the form should save the file automatically by the date with the information as shown on? SampleOrderFile