421960 Form to Email Script (not CGI)

This is probably really easy for you... I need to hook up the following web form - [login to view URL] (form is in right column). Normally I use a CGI form processor, but it doesn't look like cgi is enabled on the client's server. PHP and ASP are working fine. I need someone to hook up the form right away. Form needs to have the following... 1) All fields are required 2) After submitting, visitor is redirected to [login to view URL] Please send a cost and time estimate.