function validate() {
	alrtCode = "";
    if (document.forms[0].Name.value == ""){
		alrtCode = alrtCode += "\n     -  Full Name";
	}
    
	if (document.forms[0].StateOfBirth.value == ""){
		alrtCode = alrtCode += "\n     -  State of Birth";
	}

	
	if(document.forms[0].Address.value == ""){
		alrtCode = alrtCode += "\n     -  Address";
	}
	
	if(document.forms[0].City.value == ""){
		alrtCode = alrtCode += "\n     -  City";
	}
	
	if(document.forms[0].State.value == ""){
		alrtCode = alrtCode += "\n     -  State";
	}
	
	if(document.forms[0].Zipcode.value == ""){
		alrtCode = alrtCode += "\n     -  Zip Code";
	}
	
	if(document.forms[0].AuthorityOver.value == ""){
		alrtCode = alrtCode += "\n     -  Question number 6";
	}
	
	if(document.forms[0].Phone.value == ""){
		alrtCode = alrtCode += "\n     -  Phone Number";
	}
	if (document.forms[0].Email.value != ""){
			if (document.forms[0].Email.value.indexOf("@") == -1 
				|| document.forms[0].Email.value.indexOf(".") == -1
				|| document.forms[0].Email.value == ""){
   			alrtCode = alrtCode += "\n     -  Incorrect Email Address";
			}
		}
		
		if (alrtCode != "") {
		alrtCode ="____________________________________\n" +
		"You failed to correctly fill in the following field(s):\n" +
		alrtCode + "\n__________________________________" +
		"\nWe can not mail you a FREE sample publication\nwithout these fields\n\nPlease re-enter the required details and submit again!";
	
		alert(alrtCode);
		return false;
	}
	else return true;
}