i want to add a configuration form for a block.the form's style is as belowing

    one year (label)            input text box value    eg:$10     
    two years            input text box value     
    three years          input text box   
    500 accounts         input text box   
    1500 accounts        input text box   
    2500 accounts       input text box   
    image:              can upload an image

how do i do? i should write a module to get that.

1, how do i design the table, which used to store the input box value and image value.eg: the table is `example`. how to design the fields? thank you.

2,which hook i should use?