Custom Form + Module for OSCommerce Store - x 2 Websites

2 Websites - Exactly the same Programming & Layouts (but different visuals) - both need the exact same custom form & module. >>>>>> See Screen Shots attached. 1. when the 'Register Now' button is clicked on, I need the custom form page to come up, which is for 'Fundraiser Registration' 2. the form data, once submitted, must be stored in the database with a custom module written under administration called "Fundraiser Accounts". I must be able to go into that and pull up the fundraisers details just like I would any other customer (but it is in a separate area, of course) 3. I must be able to send out 'Newsletters' to my customers based on if they are a 'Customer' (normal) or to send out a newsletter to the 'Fundraiser Accounts' group. (a radio button is OK, or a drop down list, for me to choose which group to send it to) ********************************* 1 more small job: I need a single button inserted just under "categories" in the left-hand side menu. This needs to be done on the 2 websites (one button each website), with a link. That's all. ********************************* MY DEADLINE: I need this COMPLETE within 3 days... it can NOT go over deadline! it is URGENT! --------------------------------------------------------- NOTES: - Country Field in the form - must only be able to select "Australia" - Select State field in the form - these are the options: Australian Capital Territory New South Wales Northern Territory Queensland South Australia Tasmania Victoria Western Australia - Group Type field in the form are these options: Please Select Day Care Centre Play Group Kindergarden Mothers Group Social Group Primary School School Fete Secondary School Fishing Club Yacht Club Country Club Womens Club Knitting Club Childrens Club Awareness Club Charity Sports Club Other - How Many do you Estimate to be in your Group - options are: 1-5 in Group 5-25 in Group 25-75 in Group 75-150 in Group 150-300 in Group 300-500 in Group 500-1000 in Group 1000-2000 in Group 2000-5000 in Group 5000+ in Group