Online Web Forms

I have a website : ( [login to view URL] ) that I need an online form with payment integration that its fields are easy to edit on my side as I am going to update it a lot. My budget is $30-$60. The form should do the following: 1- Take all required info from the customer 2- When the customer changes a certain value the price is updated on the same page automatically 3- Once the customer click Pay (We use paypal). It will take him to Paypal for payment 4- This feature is very important. If the customer SUCCESSFULLY pay then I want an email to be sent to me and to the customer with all submitted data 5- Save the form entry data to a database that I can have access to and I can extract to spread sheet every time I need to 6- Has verification for fields 7- Field entries include drop down menus, email, 15 digit number, and maybe text input fields ** If the customer cancel the payment or if they don't pay I don't want to have anything saved on the database or sent to me or them ** The form should load quickly and without delay and it should look similar to my current forms like the one here: [login to view URL]