jquery mobile php form

Hi all, To make it easy for people to order from an Avon catalog with their smart phones, I've developed a basic mobile website using jquery mobile with a form they can use to submit their order to the Avon Rep. Go to [login to view URL] and click on the "Place an order" button to view the form. Site can be viewed from any smart phone browser. I need the order form to be programmed in PHP and be compatible with jquery mobile. It needs to provide 5 main functions after user clicks submit: 1. Check to make sure all fields have been filled in. Provide error message on page if not. 2. Send form information to Avon Rep's email address for ordering of products. 3. Send form information to "buyer" email address as a receipt (email address provided in the form). 4. Re-direct buyer to "Thank you" page after information has been sent successfully. 5. Provide a time stamp in both emails sent to Avon Rep and buyer. We are not going to store the information, or use the information anywhere else, so no database is required. Programmer may need a [login to view URL] account to complete this job...