I will order a calculator connected to the form. This will be a flight connection calculator.
The user has two fields to fill in: starting place, destination. The calculator, using Google Maps or another map, should calculate the distance between points and then calculate the cost of transport between points A and B and the suggested transport time. The user should be shown the amount and time. Actually, 3 amounts and 3 different times (they differ in coefficients, for easier illustration a faster and slower plane). A form with a phone number, e-mail and selected points should appear under the results.
Ultimately, the calculator / form will be installed on the Wordpress website.
I don't insist on a Google map, it might as well be OpenStreetMap or something else.
Attached is a simplified mock-up of the form, I am open to other solutions.