Trying to collect dues for a club

[prelks]

I'm in the USA. I'm trying to set up a page where i can send our members to:

1. Pay their annual dues (required)
2. Donate to our National Charity (optional)
3. Donate to our State Charity (optional)

I would like the fee passed along to the member. Is there any way to do this? It's been frustrating to say the least. Any help is appreciated.