What is JotForm?
JotForm is a free online form builder which helps you create online forms without writing a single line of code. No sign-up required.
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Widget Request - Is there a widget that allows the dual drop down selection as in the example?Asked by jonrfreier on May 14, 2014 at 12:00 PM
JotForm Support Manager
You might want to try our Dynamic dropdowns widget, which will allow you to nest option in your dropdown list.
Let us know if this doesn't fit your scenario.