First Name:

Last Name:

State:   Zip Code:

Phone: - -

Work Phone

Comments: Whenever the user presses 'Submit Data', a javascript code checks the user input and returns the user to the first input box that needs to be corrected.

• User must enter at least 1 letter in 'First Name' and 'Last Name'
• 'State' must be exactly 2 upper case letters
• 'Zip Code' must be exactly 5 digits
• 'Phone' must be ddd-ddd-dddd with no leading zeros or ones for the area code or exchange
• 'Work Phone' must be exactly (ddd) ddd-dddd with no leading zeros or ones for the area code or exchange

 or