Credit Card Info Input Form

I need a Windows forms application for inputting Credit Card information into a database. The form will allow the user to input this information to save in my database. The CC number will be encrypted and the encryption would preferably be done using .net Enterprise Library 2.0 Cryptography block, but is up to the developer. The encryption must be done in the application though, and not in the db. I will supply the build script for the db tables. The SQL should be either stored procs or typed datasets, but no directly embedded sql. The form should be in the exe and the db logic in a dll. This should be a pretty quick straightforward project. I am posting it here as I do not have the time to do it myself. I would also need the full source code. Thank you