function getForm(name) {
	var main = document.getElementById('main');

	var singleQuote = "'"

	if (name == "info") {

			main.style.height="1036px";

			function validateField(fieldId, fieldBoxId, fieldType, required)
			{
				fieldBox = document.getElementById(fieldBoxId);
				fieldObj = document.getElementById(fieldId);

				if(fieldType == 'text'  ||  fieldType == 'textarea'  ||  fieldType == 'password'  ||  fieldType == 'file'  ||  fieldType == 'phone'  || fieldType == 'website')
				{	
					if(required == 1 && fieldObj.value == '')
					{
						fieldObj.setAttribute("class","mainFormError");
						fieldObj.setAttribute("className","mainFormError");
						fieldObj.focus();
						return false;					
					}

				}


				else if(fieldType == 'menu'  || fieldType == 'country'  || fieldType == 'state')
				{	
					if(required == 1 && fieldObj.selectedIndex == 0)
					{				
						fieldObj.setAttribute("class","mainFormError");
						fieldObj.setAttribute("className","mainFormError");
						fieldObj.focus();
						return false;					
					}

				}


				else if(fieldType == 'email')
				{	
					if((required == 1 && fieldObj.value=='')  ||  (fieldObj.value!=''  && !validate_email(fieldObj.value)))
					{				
						fieldObj.setAttribute("class","mainFormError");
						fieldObj.setAttribute("className","mainFormError");
						fieldObj.focus();
						return false;					
					}

				}



			}

			function validate_email(emailStr)
			{		
				apos=emailStr.indexOf("@");
				dotpos=emailStr.lastIndexOf(".");

				if (apos<1||dotpos-apos<2) 
				{
					return false;
				}
				else
				{
					return true;
				}
			}


			function validateDate(fieldId, fieldBoxId, fieldType, required,  minDateStr, maxDateStr)
			{
				retValue = true;

				fieldBox = document.getElementById(fieldBoxId);
				fieldObj = document.getElementById(fieldId);	
				dateStr = fieldObj.value;


				if(required == 0  && dateStr == '')
				{
					return true;
				}


				if(dateStr.charAt(2) != '/'  || dateStr.charAt(5) != '/' || dateStr.length != 10)
				{
					retValue = false;
				}	

				else	// format's okay; check max, min
				{
					currDays = parseInt(dateStr.substr(0,2),10) + parseInt(dateStr.substr(3,2),10)*30  + parseInt(dateStr.substr(6,4),10)*365;
					//alert(currDays);

					if(maxDateStr != '')
					{
						maxDays = parseInt(maxDateStr.substr(0,2),10) + parseInt(maxDateStr.substr(3,2),10)*30  + parseInt(maxDateStr.substr(6,4),10)*365;
						//alert(maxDays);
						if(currDays > maxDays)
							retValue = false;
					}

					if(minDateStr != '')
					{
						minDays = parseInt(minDateStr.substr(0,2),10) + parseInt(minDateStr.substr(3,2),10)*30  + parseInt(minDateStr.substr(6,4),10)*365;
						//alert(minDays);
						if(currDays < minDays)
							retValue = false;
					}
				}

				if(retValue == false)
				{
					fieldObj.setAttribute("class","mainFormError");
					fieldObj.setAttribute("className","mainFormError");
					fieldObj.focus();
					return false;
				}
			}
			function validatePage1()
			{
				retVal = true;
				if (validateField('field_1','fieldBox_1','text',1) == false)
 retVal=false;
if (validateField('field_2','fieldBox_2','email',1) == false)
 retVal=false;
if (validateField('field_3','fieldBox_3','phone',1) == false)
 retVal=false;
if (validateField('field_4','fieldBox_4','text',1) == false)
 retVal=false;
if (validateField('field_5','fieldBox_5','textarea',1) == false)
 retVal=false;

				if(retVal == false)
				{
					alert('Please correct the errors.  Fields marked with an asterisk (*) are required');
					return false;
				}
				return retVal;
			}
		document.getElementById('formDiv').innerHTML = ('<p>Would you like us to send something in the mail? We' + singleQuote + 're sorry, but an insurance agent will probably exceed the size and weight limit for the US Postal Service, UPS, Fed-Ex, etc.  But if you fill out the following form, one of our agents will be happy to give you mind-blowing personal service.</p><form method=post enctype=multipart/form-data action=info.php onSubmit="return validatePage1();"><table cellpadding="2" cellspacing="0" border="0" bgcolor="#FFFFFF"><tr><td><font face="Verdana" size="2" color="#000000"></font> <div style="" id="mainmsg"> </div></td></tr></table><br><table cellpadding="2" cellspacing="0" border="0" bgcolor="#FFFFFF"><tr valign="top"> <td nowrap><font face="Verdana" size="2" color="#000000">Your Name</font></td> <td><input class=mainForm type=text name=field_1 id=field_1 size="30" value=""> </td></tr><tr valign="top"> <td nowrap><font face="Verdana" size="2" color="#000000">Your Email Address</font></td> <td><input class=mainForm type=email name=field_2 id=field_2 size=30 value=""> </td></tr><tr valign="top"> <td nowrap><font face="Verdana" size="2" color="#000000">Telephone Number</font></td> <td><input class=mainForm type=phone name=field_3 id=field_3 size=30 value=""> </td></tr><tr valign="top"> <td nowrap><font face="Verdana" size="2" color="#000000">Subject</font></td> <td><input class=mainForm type=text name=field_4 id=field_4 size="30" value=""> </td></tr><tr valign="top"> <td nowrap><font face="Verdana" size="2" color="#000000">Message</font></td> <td><textarea class=mainForm  name=field_5 id=field_5 rows=10 cols=60></textarea><br> </td></tr><tr> <td colspan="2"><table cellpadding=5 cellspacing=0 bgcolor="#E4F8E4" width="100%"><tr bgcolor="#AAD6AA"><td colspan="2"><font color="#FFFFFF" face="Verdana" size="2"><b>Image Verification</b></font></td></tr><tr><td style="padding: 2px;" width="10"><img src="includes/forms/CaptchaSecurityImages.php" alt=""></td><td valign="top"><font color="#000000">Please enter the text from the image</font>   <br><input id="captchaForm" name="security_code" class="mainForm" type="text"/></td></tr></table></td></tr><tr> <td> </td> <td align="right"><input id="saveForm" class="mainForm" type="submit" value="Submit" /><input type="reset" class="btn" value="  Clear Fields  " name="Clear"></td></tr><tr><td colspan=2 align="center"><br></td></tr></table></form>');
	} else
	if (name == "quote") {

			main.style.height="2142px";


			function validateField(fieldId, fieldBoxId, fieldType, required)
			{
				fieldBox = document.getElementById(fieldBoxId);
				fieldObj = document.getElementById(fieldId);

				if(fieldType == 'text'  ||  fieldType == 'textarea'  ||  fieldType == 'password'  ||  fieldType == 'file'  ||  fieldType == 'phone'  || fieldType == 'website')
				{	
					if(required == 1 && fieldObj.value == '')
					{
						fieldObj.setAttribute("class","mainFormError");
						fieldObj.setAttribute("className","mainFormError");
						fieldObj.focus();
						return false;					
					}

				}


				else if(fieldType == 'menu'  || fieldType == 'country'  || fieldType == 'state')
				{	
					if(required == 1 && fieldObj.selectedIndex == 0)
					{				
						fieldObj.setAttribute("class","mainFormError");
						fieldObj.setAttribute("className","mainFormError");
						fieldObj.focus();
						return false;					
					}

				}


				else if(fieldType == 'email')
				{	
					if((required == 1 && fieldObj.value=='')  ||  (fieldObj.value!=''  && !validate_email(fieldObj.value)))
					{				
						fieldObj.setAttribute("class","mainFormError");
						fieldObj.setAttribute("className","mainFormError");
						fieldObj.focus();
						return false;					
					}

				}



			}

			function validate_email(emailStr)
			{		
				apos=emailStr.indexOf("@");
				dotpos=emailStr.lastIndexOf(".");

				if (apos<1||dotpos-apos<2) 
				{
					return false;
				}
				else
				{
					return true;
				}
			}


			function validateDate(fieldId, fieldBoxId, fieldType, required,  minDateStr, maxDateStr)
			{
				retValue = true;

				fieldBox = document.getElementById(fieldBoxId);
				fieldObj = document.getElementById(fieldId);	
				dateStr = fieldObj.value;


				if(required == 0  && dateStr == '')
				{
					return true;
				}


				if(dateStr.charAt(2) != '/'  || dateStr.charAt(5) != '/' || dateStr.length != 10)
				{
					retValue = false;
				}	

				else	// format's okay; check max, min
				{
					currDays = parseInt(dateStr.substr(0,2),10) + parseInt(dateStr.substr(3,2),10)*30  + parseInt(dateStr.substr(6,4),10)*365;
					//alert(currDays);

					if(maxDateStr != '')
					{
						maxDays = parseInt(maxDateStr.substr(0,2),10) + parseInt(maxDateStr.substr(3,2),10)*30  + parseInt(maxDateStr.substr(6,4),10)*365;
						//alert(maxDays);
						if(currDays > maxDays)
							retValue = false;
					}

					if(minDateStr != '')
					{
						minDays = parseInt(minDateStr.substr(0,2),10) + parseInt(minDateStr.substr(3,2),10)*30  + parseInt(minDateStr.substr(6,4),10)*365;
						//alert(minDays);
						if(currDays < minDays)
							retValue = false;
					}
				}

				if(retValue == false)
				{
					fieldObj.setAttribute("class","mainFormError");
					fieldObj.setAttribute("className","mainFormError");
					fieldObj.focus();
					return false;
				}
			}
			function validatePage1()
			{
				retVal = true;
				if (validateField('field_1','fieldBox_1','text',1) == false)
 retVal=false;
if (validateField('field_2','fieldBox_2','textarea',1) == false)
 retVal=false;
if (validateField('field_3','fieldBox_3','textarea',1) == false)
 retVal=false;
if (validateField('field_4','fieldBox_4','textarea',1) == false)
 retVal=false;
if (validateField('field_5','fieldBox_5','textarea',1) == false)
 retVal=false;
if (validateField('field_6','fieldBox_6','textarea',1) == false)
 retVal=false;
if (validateField('field_7a','fieldBox_7a','text',1) == false)
 retVal=false;
if (validateField('field_7c','fieldBox_7c','text',1) == false)
 retVal=false;
if (validateField('field_8','fieldBox_8','phone',1) == false)
 retVal=false;
if (validateField('field_9','fieldBox_9','email',1) == false)
 retVal=false;
if (validateField('field_10','fieldBox_10','textarea',1) == false)
 retVal=false;

				if(retVal == false)
				{
					alert('Please correct the errors.  Fields marked with an asterisk (*) are required');
					return false;
				}
				return retVal;
			}
		document.getElementById('formDiv').innerHTML = ('<p>To get quotes for any of our products you can submit this form and one of our agents will contact you with the best quotes.</p><form method=post enctype=multipart/form-data action=quote.php onSubmit="return validatePage1();"><table cellpadding="2" cellspacing="0" border="0" bgcolor="#FFFFFF"><tr><td><font face="Verdana" size="2" color="#000000"></font> <div style="" id="mainmsg"> </div></td></tr></table><br><table cellpadding="2" cellspacing="0" border="0" bgcolor="#FFFFFF"><tr valign="top"> <td><font face="Verdana" size="2" color="#000000">1) Name of the person that we should contact.</font></td> <td><input class=mainForm type=text name=field_1 id=field_1 size="60" value=""> </td></tr><tr valign="top"> <td><font face="Verdana" size="2" color="#000000">2) Names, ages and birth-dates for all family members:</font></td> <td><textarea class=mainForm  name=field_2 id=field_2 rows=10 cols=60></textarea><br> </td></tr><tr valign="top"> <td><font face="Verdana" size="2" color="#000000">3) Do any of the listed family members use tobacco?  Please specify.</font></td> <td><textarea class=mainForm  name=field_3 id=field_3 rows=10 cols=60></textarea><br> </td></tr><tr valign="top"> <td><font face="Verdana" size="2" color="#000000">4) Have any family members received treatment in the last 5 years for any injury or illness? Please specify.</font></td> <td><textarea class=mainForm  name=field_4 id=field_4 rows=10 cols=60></textarea><br> </td></tr><tr valign="top"> <td><font face="Verdana" size="2" color="#000000">5) Are any family members currently taking any type of maintenance prescription medications? Please specify.</font></td> <td><textarea class=mainForm  name=field_5 id=field_5 rows=10 cols=60></textarea><br> </td></tr><tr valign="top"> <td><font face="Verdana" size="2" color="#000000">6) Are all family members within "normal" height and weight guidelines? If not sure, please provide information.</font></td> <td><textarea class=mainForm  name=field_6 id=field_6 rows=10 cols=60></textarea><br> </td></tr><tr valign="top"> <td><font face="Verdana" size="2" color="#000000">7) Home Address</font></td> <td><input class=mainForm type=text name=field_7a id=field_7a size="60" value=""><br> </td></tr><tr valign="top"> <td><font face="Verdana" size="2" color="#000000">Apt/Unit #</font></td> <td><input class=mainForm type=text name=field_7b id=field_7b size="60" value=""><br> </td></tr><tr valign="top"> <td><font face="Verdana" size="2" color="#000000">City, State Zip/Postal Code</font></td> <td><input class=mainForm type=text name=field_7c id=field_7c size="60" value=""><br> </td></tr><tr valign="top"> <td><font face="Verdana" size="2" color="#000000">8) Telephone Number</font></td> <td><input class=mainForm type=phone name=field_8 id=field_8 size=30 value=""><br> </td></tr><tr valign="top"> <td><font face="Verdana" size="2" color="#000000">9) Email Address</font></td> <td><input class=mainForm type=email name=field_9 id=field_9 size=30 value=""></td></tr><tr valign="top"> <td><font face="Verdana" size="2" color="#000000">10) Product(s) of interest</font></td> <td><textarea class=mainForm  name=field_10 id=field_10 rows=10 cols=60></textarea><br> </td></tr><tr> <td colspan="2"><table cellpadding=5 cellspacing=0 bgcolor="#E4F8E4" width="100%"><tr bgcolor="#AAD6AA"><td colspan="2"><font color="#FFFFFF" face="Verdana" size="2"><b>Image Verification</b></font></td></tr><tr><td style="padding: 2px;" width="10"><img src="includes/forms/CaptchaSecurityImages.php" alt=""></td><td valign="top"><font color="#000000">Please enter the text from the image</font>   <br><input id="captchaForm" name="security_code" class="mainForm" type="text"/></td></tr></table></td></tr><tr> <td> </td> <td align="right"><input id="saveForm" class="mainForm" type="submit" value="Submit" /><input type="reset" class="btn" value="  Clear Fields  " name="Clear"></td></tr><tr><td colspan=2 align="center"><br></td></tr></table></form>');
	}
}