What plugin can make a customizable check out form?

I need a check out form that looks similar to the link below.

https://2nlizv2n463m4ezbxb1ci6m1.wpengine.netdna-cdn.com/wp-content/uploads/2011/11/Screen-Shot-2013-05-23-at-13.29.09-620×321.png

As you can tell this is not a check out form but I need the elements on the bottom box(option label, option price, min,max). The most important function I need is the new option button.

I am about to create an order form for customers where they can fill in their contact information along with the product they need. The product part will be the same as the link above where they can customize their own product and add additional products as well.

Any pointers on where I can do something like this? plugins or templates?

Thanks everyone