Enhanced PDF Form

We email a one page word or PDF doc to customer to sign up with contact info and credit card info. They print, complete and fax it back. I like to be able to email this form and have the client open it as a pdf, fill it out on the computer and email it back with a credit card number on the doc. Acrobat offers what looks like a neat process for this. We need to be able to edit the dates, names and price in Arobat based on each client.