WE NEED HELP creating a single Form in Javascript. Can you help us?

Our Nonprofit institution is trying to raise donations to save a historical mill. We offer various “thank you gifts” for various donations, and we are currently using PayPal to let them transfer funds to the cause. But we need a form that will also capture their mailing info to send these gifts to them for donating.

I need someone to help us write one Javascript form that will:
1.) allow donors to enter a donation amount or select from a drop down menu (and if they selected a TShirt, they should be able to choose sizes SM, MED, LG or XLG);
2.) Fill out a form that gets emailed to info@LoudermilkMill.org, so we know where to send the gift; and
3.) transfer their donation into our account by way of PayPal (unless someone knows a more elegant donation solution without transfer fees).

The Donation page is at: http://LoudermilkMill.org/Donate.html 

This is not a huge or complex project; we just need it done soon.

Please  contact me and let me know if you can help… THANK YOU!