allowing form to load based on location

Hi,
I have support access on for nscplc.com. I have a forminator form here:
http://www.nscplc.com/contact-us/

As you can see there are two locations. The client wants the user to be able to click a drop down menu and fill out a form to go to a specific office. Is that possible? It can even be on the same form. They could click either a pull down that says "reston" or "mclean" and the form be sent to the office manager for that location.