We are looking for something very similar to
Though you would just click a button for set amount i.e. 5, 10, 25, 50, 100
To be clear we ONLY need the basic working form we will style this in keeping with the design of the website.
So as we look at it everything will just be black text, but a working quotation system as with the example above.
This is to run on a Wordpress website structure so I'm guessing php is the way.