How to collect client information and specific payment amount during a checkout process?

[wiseanttech_m]

Hi!
Is there a way to create this kind of payment method in square Online?
I need a payment method that collects clients' information (name, address, phone, and email), and at the same time, clients can enter the required amount.

Here is an example:
https://form.jotform.com/202[Redacted]0