Problems with the tech support case submission Web form

I wanted to submit a technical support case for Backup Exec, but the Web form for creating a support case seems to be broken.  It's necessary to directly call the 1-800 number to create a case.  The actual Backup Exec issue is irrelevant here because (out of necessity) I created a case via phone. 

The behavior is this: When you get to the account selection page (you've just clicked "I still need help!"), clicking the Next button simply clears the selected check box next to the selected account.  If you check "My account is not listed" and enter some details exactly the same thing happens. 

This is the same behavior I reported the last time I had a technical support issue a few months ago. (I tried reporting it to tech support and wound up with two simultaneous cases about the Backup Exec issue). I experience the same behavior in several different browsers.  symantec.com is in trusted sites.