Text Field Option

Is it possible to make a one text field option but with multiple lines ? Each ( ) below would be a text box for the customer to enter there info ? I know there is a text area but all that does is put up a box. Looking for separate fields but under one option

Example
line1: (Please Enter Where You Born )
line2: (What Hospital Were Your Born )
line3: (What Time Were You Born )

Here is a picture of what I am looking for http://awesomescreenshot.com/08020s9f0d

Thanks guys any help would be great.

why not just create the option with their names with those brackets?

MarketInSG wrote:why not just create the option with their names with those brackets?

I am assuming you are saying set up a text field for each different option ? The problem is that this is for one product and i didnt want to add that many options every time i add a product with those options. Any other idea ? or am i not understanding you correctly ?

thanks

you can use the copy function to copy the products over, that should save you time in creating options

Guys still looking for for this if it can be made please let me know. thanks