Which widget do I need to complete my form

Which widget do I need to use to complete my form? I need to add a field for "Quantity" on each line item next to the SAMPLES and the LITERATURE individual items.

This is what I am working on so far...

Check Box : checkbox : Paint Sample Set PL015-01 : Quantity? : dropdown : 1, 2, 3, 4, 5, 6, 7, 8, 9, 10 : Please Select

Check Box : checkbox : Laminate Sample Set PL015-02 : Quantity? : dropdown : 1, 2, 3, 4, 5, 6, 7, 8, 9, 10 : Please Select 

Check Box : checkbox : Fabric Chainset PL015-03 : Quantity? : dropdown : 1, 2, 3, 4, 5, 6, 7, 8, 9, 10 : Please Select

Check Box : checkbox : Ultra Surface 6x6 inch block PL015-04 : Quantity? : dropdown : 1, 2, 3, 4, 5, 6, 7, 8, 9, 10 : Please Select

I used the Purchase Order widget as some of the others are not recommended for use on a mobile device. I set the price to zero, then added custom CSS to remove the word free from each entry.

.form-product-details {
display:none;
}

Thank you so much for updating us with the solution that you have found to fix your form. I have checked your form and was able to see what you mean. We're glad to know that you have found a workaround. Should you have any other concerns or questions, please feel free to let us know and we will be glad to help you. Thank you.