Website is www.wheelrepairservices.co.nz

Now im looking at making a promotion page, what im stuck with is where do i go to start like a form entry,

i want just say there Name, Email, Job description, then i would like a drop down box with how many wheels eg 1 2 3 4. another drop down with "painted" "machined" etc. Then a calender box with to book a time. Where do i start!! i have a temp contact 7 form where they can just enter it put im kinda stuck to make it professional. its wordpress so is there a plugin i should be looking at? im new here so i say sorry in regards if ive done anything wrong.