CANNOT MAKE FORM... PLEASE HELP

I'm attempting to make a form, and I cannot seem to make it work the manner in which I need.  I've attached a screen shot and I would appreciate feedback.

(Use as reference when screenshot opened)-- I simply need my members to:

1) Input header information (Member/Business Name, Date, and Form Completed By fields - mandatory response)

2) Select their membership package (Corporate, Platinum, Gold, Silver, Emerald, OR Copper - mandatory response via check box), and

3) After they select their package in #2, I want all other columns BUT the corresponding one to be grayed out so they can work vertically (and to avoid error in choosing benefits for incorrect packages).  They just need to be able to write the number of tickets (top section) and sponsorship credits (bottom section) they would like to redeem for the year.

HOW DO I DO THIS???????????