It's an order form.
Process all fields, and dispatch an e-mail to me with all details and payment choice, and an e-mail (template) to the user with login url, user/pass, etc.
Some fields need to be *required* by the form, and some do not.
Redirect the user to the appropriate payment url. ie: /cc.html, /paypal.html, /epass.html.. whatever...
Something like that.
Bit it
ICQ 121760557
Thanks.