<select>
<option>Seleccione un valor</option>
<option value = "a">A</option>
<option value = "b">B</option>
<option value = "c">C</option>
</select>
A <input type = "checkbox" name = "a" />
B <input type = "checkbox" name = "b" />
C <input type = "checkbox" name = "c" />