Convert Java "incentive style page" into HTML

Right now this page is in Javascript. The box pop's up in Javascript. [login to view URL] I would like this to be an ALL ONE HTML page, no iframes, no javascript. I also have code for the Credit card form which will need to be replaced with the code that is currently in there. Would like to discuss the specifics of this project is before we get started over PM. I need this complete in 1-2 days.