test.html

<form action="/admin/safety_training_courses" accept-charset="UTF-8" method="post"><input name="utf8" type="hidden" value="✓"><input type="hidden" name="_method" value="update"><input type="hidden" name="authenticity_token" value="lk9Fm7n7wZ4dYQ4wyFsgujIwbI5iJrfCgmFT2xYR0IN2zAlYZVJ8HMkUJOvRucX3bEvBku6mXF17DfNUDXljDQ==">
          <div class="gray-box">
            Industry
            <select name="industry" id="industry"><option value="1">Testing</option>
            <option value="2">Construction</option>
            <option selected="selected" value="3">Development</option></select>
          </div>
          <div id="subindustries"></div>
          <div class="gray-box" data-entry="">
            Sub-Industry
            <select data-toggle="change" name="subindustry[]">
              <option selected="selected" value="4">
                Php
              </option>
              <option value="7">
                Ruby
              </option>
            </select>
          </div>
          <div class="gray-box" data-entry="">
            Sub-Industry
            <select data-toggle="change" name="subindustry[]">
              <option selected="selected" value="5">
                Laravel Framework
              </option>
            </select>
          </div>
          <div class="gray-box" data-entry="">
            Sub-Industry
            <select data-toggle="change" name="subindustry[]">
              <option selected="selected" value="9">
                helpers
              </option>
            </select>
          </div>
          <div class="hazards">
            Optional Safety Hazards
            <span>
              Check any of the safety hazards below that are present in your operations
            </span>
            <div id="courses">
              <div class="cols2">
                <ul>
                </ul>
              </div>
            </div>
          </div>
          <div class="clear"></div>
          <div class="gray-box">
            Prioritize your training
            <a class="course_priorities_button ajax_lightbox_trigger" id="priorities-your-courses" lbstyles="width: 500px; margin-top: 5%" href="/admin/safety_training_courses/priorities_your_courses">Course Priorities</a>
            <input value="{}" type="hidden" name="course_priorities[]" id="course_priorities_">
          </div>
          <div class="schedule gray-box">
            Choose a training schedule
            <br>
            <select name="interval_time_range_id" id="interval_time_range_id"><option selected="selected" value="1">15 minutes of training</option>
            <option value="2">30 minutes of training</option>
            <option value="3">45 minutes of training</option>
            <option value="4">1 hour of training</option>
            <option value="5">1.25 hours of training</option>
            <option value="6">1.5 hours of training</option>
            <option value="7">2 hours of training</option>
            <option value="8">3 hours of training</option></select>
            <select name="interval_date_range_id" id="interval_date_range_id"><option selected="selected" value="1">Once a week</option>
            <option value="2">Every two weeks</option>
            <option value="3">Every month</option>
            <option value="4">Every six weeks</option>
            <option value="5">Every two months</option>
            <option value="6">Every three months</option></select>
          </div>
          <input type="submit" name="commit" value="Save your Changes" class="blue-button">
        </form>