Data Entry Portal . Convert XL data entry to web based

This should be a fairly easy project. I currently use XL with basic scripting for data entry. Need to have someone convert this to web based data entry. All I need is a form when I can enter data and the data is written to a text file (fields separated by comma - a csv file). I have attached a screen shot. Requirements: 1. Data needs to be appended to the txt (csv) file 2. Option to change the data file name 3. Display last data entered at the bottom of screen, with an option to delete a particular record.