How to DISPLAY an ORDER FORM for my company

Could someone please tell me how to fix up an Order form so in Dreamweaver MX? I mean: On my company website, we need to add our order form, which includes the tables that read: ‘bill to’, ‘ship to’, ‘name’, ‘address’, ‘city’, ‘state’, ‘zip’, ‘tel’, ‘fax’, the ‘amount’ & ‘product numbers’ of requested products.
It’s a sheet that the viewer, intending to order merchandise from us, has to fill out.
My boss wishes that the client should be able to fill out the order form through the BROWSER, and when they click ‘submit’ for all that information to be sent to the business ip. Do you know how I would go about doing this? I have attached the protocol order form, for a visual. If you know how to fix it up to be the way I’m asking, please help me out. Thank you greatly.