Create Subcategory option in adobe acrobat pro

Hello,
I am trying to create form like this ( National Healthcare Achievers, 2015 | Nominate ). I am done with everything but i don't know how to create following functionality with adobe acrobat pro. Even any alternative solution will work too. But i need to distinguish every category. Kindly help.
Thanks

The link you posted gives me a 404 page not found error.

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