If you have the legacy landing page goal in the campaign builder, you could build it there.

You just need to create 6 custom fields - drop-downs make the most sense. Something like this
If you want to get fancy, you could get something like survey gizmo and make a really nice survey that allows ranking by dragging objects in their preferred order. But, you would need a survey monkey/gizmo account and probably zapier or parsey to sync the survey results to your app.