First Name:
Last Name:
Street Address:
City:
State:
Zip:
Email:
Telephone Number
Are you currently on our mailing list?
Would you like to get email only notifications?
How did you hear about our company?
$sql = "INSERT INTO customer SET " . "firstname='$firstname', " . "lastname=$lastname', " "street='$street', " "city='$city', " "zip='$zip', " "email='$email', " "phone_numver='$phone_number', " if (mysql_query($sql)) { echo("
Your joke has been added.
"); } else { echo("
Error adding submitted joke: " . mysql_error() . "
"); }
