jerseygoat

I'm having a hell of a time trying to create this specific form. Can anyone please help.
The first part of the form is a spot where they need to select an available "block" So with a title "choose a block" or something and then maybe a drop down menu with a list of the available blocks. There are 45 blocks. Each block is priced differently, so i need each block (1-45) to have a price associated with it - that price will then be added with the second part to get the total.

the second part is where they need to choose the amount they want (1-10). For each number they want its $100, so 1=$100 2=$200 and so on. Then that number needs to be added with the first part and the total of the two would be displayed in a spot with the title "total" and the total price displayed.
Below that i need a "pay using paypal" button that when you click on it would take the total price and link to my paypal payment page.

I hope this makes sense. Please help. Thanks a lot.

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