Here it is:

<p align="center"><span class="text">Additional Locations:
<select name="locations" size="3" multiple id="locations">
         <option value="001">001</option>
         <option value="002">002</option>
         <option value="003">003</option>
         <option value="004">004</option>
         <option value="005">005</option>
</select>