WordPress Payment Page(s)

WordPress Payment Page(s)

I need an information Collection Screen for WordPress (See Attached). This is simply to collect secure information; I already have an SSL. It is not a complex check out, but Page two will require collection of credit card info. I imagine this is a simple Word Press csforms?? I have all the neccissary information in the Attachment, so I imagine this should be failry simple and fast. I’ve included my website header and footer to give you an idea of the colors/layout.

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