Add Dropdown Menu for eNewsletter

I would like to add a dropdown menu to the eNewsletter subscribe box. The dropdown will capture the email group. I have tried to add the code to a text widget and replace the checkbox input field with select / option html code. Here's what I have so far:

<div class="e-newsletter-widget" >
            <div id="message" style="color:#000000; display:none; background-color: #FFFFE0;border-color: #E6DB55;margin: 5px 0 15px;-moz-border-radius: 3px 3px 3px 3px;border-style: solid;border-width: 1px;padding: 5px;"></div>

            <form action="" method="post" name="subscribes_form" id="subscribes_form">
                <input name="newsletter_action" id="newsletter_action" value="" type="hidden">
                <div id="add_member" class="e-newsletter-widget-screen" style="position: relative; float:right; margin-top: 15px; padding-left: 40px;width:100%;">
                    <div style="width:10% !important;float: left; margin: 0 0 10px;padding-left: 3%;">&nbsp;</div>
                    <div style="width:20% !important;float: left; margin: 0 0 10px;padding-left: 3%;">
                        <input name="e_newsletter_name" id="e_newsletter_name" placeholder="First Name" type="text" style="padding: 6px;">
                    </div>
                    <div style="width:20% !important;float: left; margin: 0 0 10px;padding-left: 3%;">
                        <input name="e_newsletter_email" id="e_newsletter_email" placeholder="Email" value="" type="text" style="padding: 6px;">
                    </div>
                    <div style="width:20% !important;float: left; margin: 0 0 10px;padding-left: 3%;">
<select name="e_newsletter_groups_id[]" style="padding: 6px;">
<option value="subscribed" selected>Select a Category</option>
<option name="e_newsletter_groups_id[]" value="1">Accounting</option>
<option name="e_newsletter_groups_id[]" value="2">Admin & Clerical</option>
<option name="e_newsletter_groups_id[]" value="4">Customer Service</option>
<option name="e_newsletter_groups_id[]" value="5">Engineering</option>
<option name="e_newsletter_groups_id[]" value="6">Executive</option>
<option name="e_newsletter_groups_id[]" value="7">Banking & Finance</option>
<option name="e_newsletter_groups_id[]" value="8">Government</option>
<option name="e_newsletter_groups_id[]" value="9">Health Care</option>
<option name="e_newsletter_groups_id[]" value="10">Hospitality</option>
<option name="e_newsletter_groups_id[]" value="11">Human Resources</option>
<option name="e_newsletter_groups_id[]" value="12">Information Technology</option>
<option name="e_newsletter_groups_id[]" value="13">Internships</option>
<option name="e_newsletter_groups_id[]" value="14">Manufacturing</option>
<option name="e_newsletter_groups_id[]" value="15">Sales & Marketing</option>
<option name="e_newsletter_groups_id[]" value="16">Nonprofit</option>
<option name="e_newsletter_groups_id[]" value="17">Part Time</option>
<option name="e_newsletter_groups_id[]" value="18">Retail</option>
<option name="e_newsletter_groups_id[]" value="19">Science & Biotech</option>
<option name="e_newsletter_groups_id[]" value="20">Transportation</option>
</select>
                    </div>
                    <div style="width:20% !important;float: left; margin: 0 0 10px;padding-left: 3%;">
                        <input id="new_subscribe" class="enewletter_widget_submit" value="Subscribe" type="submit" style="padding: 10px 16px;">
                    </div>
                </div>

                <div id="subscribe_to_groups" class="e-newsletter-widget-screen" style="display:none;">
                    <p>
                        <input id="subscribe_to_groups" class="enewletter_widget_submit" value="Subscribe" type="submit">
                    </p>
                </div>
                    <div style="width:10% !important;float: left; margin: 0 0 10px;padding-left: 3%;">&nbsp;</div>
                <div id="unsubscribe_from_groups" class="e-newsletter-widget-screen" style="display:none;">
                    <p>
                        <input id="unsubscribe_from_groups" class="enewletter_widget_submit" value="Unsubscribe" type="submit">
                    </p>
                </div>
                <div id="manage_subscriptions" class="e-newsletter-widget-screen" style="display:none;">
                    <input name="unsubscribe_code" id="unsubscribe_code" value="" type="hidden">
                        <h3>Subscribe to:</h3>
                        <p>
                            </p><select name="e_newsletter_groups_id[]" style="padding: 6px;">
<option value="subscribed" selected>Select a Category</option>
<option name="e_newsletter_groups_id[]" value="1">Accounting</option>
<option name="e_newsletter_groups_id[]" value="2">Admin & Clerical</option>
<option name="e_newsletter_groups_id[]" value="4">Customer Service</option>
<option name="e_newsletter_groups_id[]" value="5">Engineering</option>
<option name="e_newsletter_groups_id[]" value="6">Executive</option>
<option name="e_newsletter_groups_id[]" value="7">Banking & Finance</option>
<option name="e_newsletter_groups_id[]" value="8">Government</option>
<option name="e_newsletter_groups_id[]" value="9">Health Care</option>
<option name="e_newsletter_groups_id[]" value="10">Hospitality</option>
<option name="e_newsletter_groups_id[]" value="11">Human Resources</option>
<option name="e_newsletter_groups_id[]" value="12">Information Technology</option>
<option name="e_newsletter_groups_id[]" value="13">Internships</option>
<option name="e_newsletter_groups_id[]" value="14">Manufacturing</option>
<option name="e_newsletter_groups_id[]" value="15">Sales & Marketing</option>
<option name="e_newsletter_groups_id[]" value="16">Nonprofit</option>
<option name="e_newsletter_groups_id[]" value="17">Part Time</option>
<option name="e_newsletter_groups_id[]" value="18">Retail</option>
<option name="e_newsletter_groups_id[]" value="19">Science & Biotech</option>
<option name="e_newsletter_groups_id[]" value="20">Transportation</option>
</select>
                        <p></p>
                    <p>
                        <input id="save_subscribes" class="enewletter_widget_submit" value="Save Subscriptions" type="submit">
                    </p>
                <p>
                    <a href="#" id="unsubscribe" class="enewletter_widget_submit">Unsubscribe</a>
                </p>
                </div>
                <div id="subscribe" class="e-newsletter-widget-screen" style="display:none;">
                    <input id="subscribe" class="enewletter_widget_submit" value="Subscribe to Newsletters" type="submit">
                </div>
            </form>
        </div>

However, this is not working. The user subscribes, but the group is not recorded. How can I fix this?

Thanks,
Chris