Trying to display text form field value on page

Trying to display text form field value on page

I have a standard HTML form that asks the user for a dollar amount and a payment date.  On the same page I want to display some acknowledgement text which displays to the user what they entered above.

For example, lets say the user entered 10.00 as the dollar amount, and 03/01/2011 as the payment date in separate HTML form text fields.  Right before the submit button I would like to display to the user "By clicking on the submit button below, I agree to pay $10.00 to Company, Inc. on 03/01/2011".

I'm sure this can be done using jQuery... I'm just having a hard time finding an example.