Wordpress Form Build with payment gateway included

need a form built similar to ivisa website, prefarerably using a wordpress form builder, ie wpforms, gavity forms, any form that we can intergrate stripe payment system into.

Please watch my video for clear explaination as to whats needed.
youtube.com/watch?v=0-3pUGTJasY

Please note, I am a UX developer so please dont waste my time in sending me outrageous times to build or quotes.
My challenge is with time constraints, not the ability to create.
This is a project at Cert 4 Level.