Contest $100 Create a form for my website

On my website (www.pcphoenix.net) if you click the "SPEED UP NOW" button, you will see this form: http://i.imgur.com/W3xUpPH.png

I don't like this form, so I'm making a new one. I'm getting rid of the "credits" feature.

This is what i came up with on my own: http://i.imgur.com/QCMArjy.png

This is a decent form, but i want to see if someone can make something even better.

$100 to anyone who can design a nice-looking simple form.

It should fit the general color scheme that i already have. And it should break down into three steps:
1) Pay with PayPal. No account required.
2) Receive Log-In Credentials instantly.
3) Download & Run PcPhoenix.

I fee it's important to have those three steps there. And then of course the button that takes them to paypal.

There should also be a button somewhere that says "Have a Discount Code?" which allows them to enter a code.

If nobody makes a form that I'm happy with (and I end up just using my own), I'll reward $50 to the person who came closest.

If you have any questions, please let me know.

 

2 Concepts:

1.


2.



Clean, Simple and Modern form.
Thanks

 

Concept:

 

My try. Feedback appreciated

 

Forgot to put the button. Revision:

 

you want and coding or just design?

 

Just the design. Ty.

 

feedback appreciated:

 

CONTEST OVER. Thank you all for your submissions. I have picked frikusha as the winner. All the designs were good, but some were more parallel to the general theme i had on my site, and some were a little further away. Before frikusha i was planning on choosing Sobbi or Monkz.

This is the final design i went with: https://forums.digitalpoint.com/proxy/Zjl03hsYz9oe7VoaA6cV62aBfpVkbWq/XDtHq1oy/image.png

Again, thanks everyone