PHP simple checkout form

I need a simple formmail page which will collect the client\'s data and credit card info and send me via email, plus it would give the client an option to pay via paypal and hence would collect the data chosen by the client and create a paypal button etc. (not sure if IPN is needed at all). [I just need the base script with a few fileds, I can fill in the rest myself. I expect this to take less than 1 hour].