Create a quick online payment page - php and authorize.net

I have a webpage and an [login to view URL] account - I need a quick payment page to accept donations. You can see the page here: [Removed by Admin] I use the Simple Checkout Method, but I need to add a couple of custom text fields to get sent to me when someone makes a payment so I can't use this anymore. *** THIS HAS TO BE DONE BY 8/19 7 AM PACIFIC TIME PLEASE ONLY BID IF YOU CAN START RIGHT NOW *** Best bid with promise to get it done today wins!