Custom order form

I need a custom order form made. I have a sample that needs modifying. I need to add my flavor descriptions and a few extra columns. I will list the column descriptions I need and the flavors listed under the description column. I will also attach I file for an example of what it should look like. Quantity Description 0mg Nic strength 12mg Nic strength 18mg Nic strength 24mg Nic strength Amount Total VAPE CANDY FLAVORS Orange Creamsicle Punch Pumpkin Pie Pango Cool mint lemon Amaretto Cheesecake Double Chocolate Hazelnut Hazelnut Cappuccino Crazy Cherry Cola Cherry Cola Cool Berry El Toro Strawberry Cheesecake S'mores Grape Pineapples Joyous Almond Peanut Butter Cup Strawberry Mint Green Apple Sweet Guava Horchata Carmel Buttered Popcorn Piña Colada Double Dipp'd Chocolate Banana Blueberry Cinnamon Crumble Cool Mint Sweet Watermelon Spearmint Vanilla French toast Strawberry Bubble Gum Mango Peach Vanilla Strawberry 'Nana Berry's Bubble Gum Watermelon Bubble Gum High5 Tobacco Red's Tobacco Red's Burning Tobacco Seven's Tobacco Cool Port Tobacco Just Tobacco