Simple Paypal Integration

Avg Bid (USD)
Project Budget (USD)
$30 - $250

Project Description:
Hi everyone!

I want to have a basic or simple website that will let you input the following data and send the amount to another paypal account(this can be constant/embeded in the code).
Lastname, Firstname, Middle Initial, Email, Street Address, Address Line 2, City, State, Zip code, Amount, Paypal Exchange Rate, and Converted Amount.

During clicking the submit button, these above data will be only be saved to MySQL database after the amount is successfully send and a message will appear if successful or not . Note: the paypal exchange rate will be retrieve via Paypal API also.

I prefer that you will use Adaptive Payments but your suggestion is also appreciated.
I don't need a fancy interface. I just want the functionality of paypal integration.

Happy bidding everyone,

Skills required:
Graphic Design, HTML, MySQL, PHP, Website Design
About the employer:
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