Add a form and product page to my wordpress site

Have a look at ([login to view URL]). We are a subscription service for sanitary napkins. Right now, you'll see if a customer wants to place the order, she'll click any of the action calls on the homepage such as 'Create a Package' or 'Get Pfiery'. On clicking, a pop up will appear asking for her brand and size. After selecting "BRAND', the price will appear as prices are linked only to brand selection, each brand has a different price. She clicks 'Add to cart' and its added, once the user clicks 'Order now', she will be directed to the Checkout page and voila. I need two things from you: 1. Link prices to the quantity she selects. If you see, currently price is linked to 'BRAND' she selects. But from now on, we only want to charge according to the quantity and there are only 2 quantities a user can select, which means only 2 prices. 2. Now, the important addition I want is to remove this pop up, and send user to a product page when she clicks 'Create a package'. The design is attached below, I'll provide the background image. This product page will contain a beautiful, minimal form and all fields must be mandatory in the form. I want no dropdowns or other selection. Need to keep it as visual as possible. I have attached the images of how it will look. I want it exactly same. Line by line, point by point, and strictly follow the spacing in the design. Only send the proposal if you think you can make it look exactly as shown in the design, desktop + mobile. Please mention 'CHAMPION' in your proposal so that I'll know that you read the description and understood it.