CFM Paypal Form Modification

We currently have a form located at [login to view URL] The form needs to have 2 more options added to it. We need one line that has a dropdown choice to select membership level and another to select sponsorship level. See attached for sample. The dropdown would contain placeholder data that we can change later : Platinum - $10000.00 Gold - $5000.00 Silver - $2500 Jade - $1000 Bronze - $500 Looking for project winner today. Project will be awarded asap.