Here is the PHP script. It worked before I rebuilt the current system and install Slackware 10 instead of Redhat 7.3.
<html>
<head>
<title></title>
</head>
<body bgcolor="#FFFFFF" text="#000000" leftmargin="0" topmargin="0" marginwidth="0" marginheight="0">
<?
$space = "_______________";
$contact_db = fopen("contact.txt", "a");
$linevar = ereg_replace("<br>","n",$linevar);
$date = date("l, F dS, Y - h:i:s A");
fwrite($contact_db, $date."\r\n");
fwrite($contact_db, $space."\r\n\r\n");
// Edit the following coding
// replace textfield1 with the name of the first textfield on your email form
// Continue this process for textfield 2 through to 15
fwrite($contact_db, $firstname."\r\n");
fwrite($contact_db, $address."\r\n");
fwrite($contact_db, $city."\r\n");
fwrite($contact_db, $zipcode."\r\n");
fwrite($contact_db, $phone."\r\n");
fwrite($contact_db, $dialup."\r\n");
fwrite($contact_db, $cardtype."\r\n");
fwrite($contact_db, $cc."\r\n");
fwrite($contact_db, $exp1."\r\n");
fwrite($contact_db, $exp2."\r\n");
fwrite($contact_db, $total."\r\n");
fwrite($contact_db, $notes."\r\n\r\n");
fclose($contact_db);
// replace
youremail@domain.com with the email you woudl like your form to submit to
// replace the Header titles with the headers you would like displayed in your email application
// replace the textfield variables wtih the names of the corresponding text fields on your form
mail("ADDEMAILADDRESS HERE", "Online Credit Card Payment", "Name on Card: $name\r\n\r\n Billing Address: $address\r\n\r\n City: $city\r\n\r\n Zip: $zipcode\r\n\r\n Home Number: $phone\r\n\r\n Dialup Account Number: $dialup\r\n\r\n Payment Type: $cardtype\r\n\r\n Credit Card #: $cc\r\n\r\n CC Expiration: $exp1, $exp2\r\n\r\n Amount to Charge Card: $total\r\n\r\n Notes and/or Addl Emails: $notes\r\n\r\n");
?>
<table width="760" border="0" cellspacing="0" cellpadding="0" align="center">
<tr>
<td> </td>
</tr>
<tr>
<td>
<table width="250" border="0" cellspacing="0" cellpadding="0" align="center">
<tr>
<td width="10"><img src="../../contact_form_submit/place_holder.gif" width="5" height="180"></td>
<td width="240" valign="top">
<div align="center"><font size="1" face="Verdana, Arial, Helvetica, sans-serif"><br>
<b><font color="#003366"><br>
<br>
<font size="2">Thank you!</font><br>
<br>
</font></b><font color="#003366">Your e-mail has been sent,
<br>
and the account will be credited in 1 - 2 business days.<br>
<br>
</font><font color=#ffffff face="Verdana, Arial, Helvetica, sans-serif"
size=2><b> </b></font></font>
<font size="1" face="Verdana, Arial, Helvetica, sans-serif"><font color="#003366"><br>
<br>
</font></font></div>
</td>
</tr>
</table>
</td>
</tr>
<tr>
<td>
</td>
</tr>
</table>
</body>
</html>