function SocialVar(Start,errStr){
var pSocVer = 0
 if(document.forms[0].elements[Start].value.length==3){pSocVer=pSocVer+1;}
 else if(document.forms[0].elements[Start].value.length!=0){pSocVer=pSocVer+2;}
 if(document.forms[0].elements[Start+1].value.length==2){pSocVer=pSocVer+1;}
 else if(document.forms[0].elements[Start+1].value.length!=0){pSocVer=pSocVer+2;}
 if(document.forms[0].elements[Start+2].value.length==4){pSocVer=pSocVer+1;}
 else if(document.forms[0].elements[Start+2].value.length!=0){pSocVer=pSocVer+2;}
if (pSocVer!=0&&pSocVer!=3){return errStr}
else{return ""}
}

function PhoneVar(Start,Stop,errStr){
var pPhVer = 0
for(i=Start;i<Stop;i++){
 if(document.forms[0].elements[i].value.length==3){pPhVer=pPhVer+1;}
 else if(document.forms[0].elements[i].value.length!=0){pPhVer=pPhVer+2;}
 }
 if(document.forms[0].elements[Stop].value.length==4){pPhVer=pPhVer+1;}
 else if(document.forms[0].elements[Stop].value.length!=0){pPhVer=pPhVer+2;}
if (pPhVer!=0&&pPhVer!=3){return errStr}
else{return ""}
}

function AddressVar(Start,errStr){
var pAddVer=0

for(i=Start;i<Start+4;i++){
if(document.forms[0].elements[i].value!=""){pAddVer=pAddVer+1;}
}
if (pAddVer!=0&&pAddVer!=4){return errStr}
else {return ""}
}

function ZipSuffixVar(Start,errStr){
if(document.forms[0].elements[Start].value.length!=5&&document.forms[0].elements[Start].value.length!=0||document.forms[0].elements[Start+1].value.length!=4&&document.forms[0].elements[Start+1].value.length!=0){return errStr}
else {return ""}
}

function EmailVar(Start,errStr){
if(document.forms[0].elements[Start].value!=""){

var reg1 = /(@.*@)|(\.\.)|(@\.)|(\.@)|(^\.)/; // not valid
var reg2 = /^.+\@(\[?)[a-zA-Z0-9\-\.]+\.([a-zA-Z]{2,3}|[0-9]{1,3})(\]?)$/; // valid

if (reg1.test(document.forms[0].elements[Start].value) || !reg2.test(document.forms[0].elements[Start].value)){return errStr};
else{return ""}
}
else{return ""}
}

function DateVar(Start,Stop,errStr){
var pBDayVer = 0
for(i=Start;i<Stop;i++){
if(document.forms[0].elements[i].selectedIndex!=0&&document.forms[0].elements[i].selectedIndex!=-1){pBDayVer=pBDayVer+1;}
}
if (pBDayVer!=0&&pBDayVer!=3){return errStr}
else{return ""}
}

function BlockData(elem_type){

if(elem_type=='paragraph'){if(event.keyCode==13){event.returnValue = false}}
if(elem_type=='alpha'){re = /[^A-Za-z -]/g; if (re.test(String.fromCharCode(event.keyCode))){event.returnValue = false}}
if(elem_type=='numeric'){re = /[^0-9]/g; if (re.test(String.fromCharCode(event.keyCode))){event.returnValue = false}}
if(elem_type==','){re = /[,]/g; if (re.test(String.fromCharCode(event.keyCode))){event.returnValue = false}}
if(elem_type=='comma'){re = /[^0-9 ,]/g; if (re.test(String.fromCharCode(event.keyCode))){event.returnValue = false}}
if(elem_type=='percent'){re = /[^0-9%]/g; if (re.test(String.fromCharCode(event.keyCode))){event.returnValue = false}}
if(elem_type=='money'){re = /[^0-9.,$]/g; if (re.test(String.fromCharCode(event.keyCode))){event.returnValue = false}}
if(elem_type=='alphaNumeric'){re = /[\'\"]/g; if (re.test(String.fromCharCode(event.keyCode))){event.returnValue = false}}
if(elem_type=='-'){re = /-/g; if (re.test(String.fromCharCode(event.keyCode))){event.returnValue = false}}
}

function BuildDateSelect(FormElem){
if(FormElem>=0){
var Days = 1
if(eval("document.forms[0].BMonth["+FormElem+"].options[document.forms[0].BMonth["+FormElem+"].selectedIndex].value")=='4'||eval("document.forms[0].BMonth["+FormElem+"].options[document.forms[0].BMonth["+FormElem+"].selectedIndex].value")=='6'||eval("document.forms[0].BMonth["+FormElem+"].options[document.forms[0].BMonth["+FormElem+"].selectedIndex].value")=='9'||eval("document.forms[0].BMonth["+FormElem+"].options[document.forms[0].BMonth["+FormElem+"].selectedIndex].value")=='11'){Days=31};
else if(eval("document.forms[0].BMonth["+FormElem+"].options[document.forms[0].BMonth["+FormElem+"].selectedIndex].value")=='2'){Days=30};
else{Days=32}

for(i=0;i<eval("document.forms[0].BDays["+FormElem+"].length");i++){if(eval("document.forms[0].BDays["+FormElem+"].length")!=0){eval("document.forms[0].BDays["+FormElem+"].options["+i+"]=null");i=i-1}}

eval("document.forms[0].BDays["+FormElem+"].options[document.forms[0].BDays["+FormElem+"].length]=new Option('','',0,0)")

for(i=1;i<Days;i++){if(i<=9){eval("document.forms[0].BDays["+FormElem+"].options[document.forms[0].BDays["+FormElem+"].length]=new Option('0'+"+i+","+i+",0,0)")}else{eval("document.forms[0].BDays["+FormElem+"].options[document.forms[0].BDays["+FormElem+"].length]=new Option("+i+","+i+",0,0)")}}
}

else{
var Days = 1
if(eval("document.forms[0].BMonth.options[document.forms[0].BMonth.selectedIndex].value")=='4'||eval("document.forms[0].BMonth.options[document.forms[0].BMonth.selectedIndex].value")=='6'||eval("document.forms[0].BMonth.options[document.forms[0].BMonth.selectedIndex].value")=='9'||eval("document.forms[0].BMonth.options[document.forms[0].BMonth.selectedIndex].value")=='11'){Days=31};
else if(eval("document.forms[0].BMonth.options[document.forms[0].BMonth.selectedIndex].value")=='2'){Days=30};
else{Days=32}

for(i=0;i<eval("document.forms[0].BDays.length");i++){if(eval("document.forms[0].BDays.length")!=0){eval("document.forms[0].BDays.options["+i+"]=null");i=i-1}}

eval("document.forms[0].BDays.options[document.forms[0].BDays.length]=new Option('','',0,0)")

for(i=1;i<Days;i++){if(i<=9){eval("document.forms[0].BDays.options[document.forms[0].BDays.length]=new Option('0'+"+i+","+i+",0,0)")}else{eval("document.forms[0].BDays.options[document.forms[0].BDays.length]=new Option("+i+","+i+",0,0)")}}
}
}

function VarifyRequest(){

var errStr=""

if(document.forms[0].elements[0].value==""||document.forms[0].elements[1].value==""){errStr=errStr+" Your first name and last name is required.      \n";}

errStr = errStr + EmailVar(2," E-mail address format incorrect.\n")
errStr = errStr + PhoneVar(3,5," Phone number incomplete.\n")
errStr = errStr + PhoneVar(7,9," Fax number incomplete.\n")

document.forms[0].elements[6].value = document.forms[0].elements[3].value+'-'+document.forms[0].elements[4].value+'-'+document.forms[0].elements[5].value
if(document.forms[0].elements[6].value=="--"){errStr=errStr+" Your phone number is required.      \n";}

document.forms[0].elements[10].value = document.forms[0].elements[7].value+'/'+document.forms[0].elements[8].value+'/'+document.forms[0].elements[9].value

if(errStr!=""){
document.forms[0].elements[6].value = ""
document.forms[0].elements[10].value = ""
alert("Error Processing Request  -  Missing Information      \n\n"+errStr)
}

 else{
  document.forms[0].action = document.forms[0].action + "?JavaPost=true"
  document.forms[0].submit();
 }
}