extra fields

Can you give me an estimate for support and possible development? I need to have some required text fields and also a question with three radio buttons. Also a check box with a yes/no question. And a paypal button, of course. I have First member name, Second member and Third member names. What’s the best way to correspond about this? Thanks.

http://ww.wp.xz.cn/plugins/cp-contact-form-with-paypal/