<form id="searchform" action="[% root_uri_rel %]/" method="get">
    <input type="hidden" name="mode" value="search" />
    <label for="name">Go to</label>
    <select name="field" class="field">
        [% FOR field=['Module', 'Distribution', 'Author'] %]
        <option [% 'selected="selected"' IF param('field') == field %]>[% field %]</option>
        [% END %]
    </select>
    <input type="text" name="name" id="name" class="text" value="[% param('name') %]"/>
    <input type="submit" />
</form>