Submit Shopping List

I want to set a form to gather buy list. Name, Email, Phone Number, Submit button must be pre-defined. The submission is as like contact form work, but the form field will be user end, user can add unlimited item to the list.

The idea is: Think you are a customer of my glossary shop & you want to send me your buy list before you reach to my shop. When I get the list in my website dashboard & email, then I can assemble all your items before you come to my shop, and you can return home without waits. This is the purpose of my finding.

Adding item to the list can be something like this http://www.jqueryscript.net/demo/Creating-A-Simple-Shopping-List-Using-jQuery/ I want a similar thing in WordPress. Can anybody help me out? Is there any plugin already doing suck work or any way I can do with? Thanks in advance.

Regards
Mohsin Alam