Cant submit a support ticket?

So I can go to the support page; type in my information but it asks for drop down menus' such as

"Select Game"
"Select Server"
"Select Character"

But alas I've tried my Galaxy Note 10.1's browser
I've tried Internet Explorer 9 32 bit on Windows Vista 64 bit OS, Desktop
I've tried Google Chrome (same as above line)
And I've tried Mozilla Firefox (same as above)

Neither of them will let me select. Now I'm hoping i can get some feedback before its too late...For example...I'm missing items on my character...if no one responds to THIS question until Friday....then I submit my support ticket Friday...for a problem that arose during this rollback Sunday...I highly doubt I will get approved.

So please...does anyone have any idea why I cant select anything? Thanks

BTW I'm using this link to fill in data....and my previous experiences with (OTHER) technical pages...is that all fields must be filled in.

https://support.perfectworld.com/app/ask