AJAX - single page insertion

Shipping process requires options for user to select shipping carrier and enter shipping account number User, upon selecting a checkbox to use their own shipping carrier and account, is then required to select from 4 shipping carriers and must enter a shipping account number for that carrier before moving to the next page in the checkout process. The account field is up to 12 alphanumeric digits and is not checked against a database for accuracy. Checkbox, shipping carrier drop down and account entry field need to be grouped together on the page. Site platform is php ecommercetemplates Project start within 24 hours of posting Prompt service upon hiring is required