function verify(gas_form) {
//Blank Check
	var blank_check = new Array();
	blank_check[0] = new Array(gas_form.name_insured, 'Please enter the name insured.');
	blank_check[1] = new Array(gas_form.mailing_address, 'Please enter the mailing address.');
	blank_check[2] = new Array(gas_form.mailing_city, 'Please enter a city.');
	blank_check[3] = new Array(gas_form.mailing_zip, 'Please enter a zip code.');
	blank_check[4] = new Array(gas_form.location_address, 'Please enter the location address.');
	blank_check[5] = new Array(gas_form.location_city, 'Please enter a city.');
	blank_check[6] = new Array(gas_form.location_zip, 'Please enter a zip code.');
	blank_check[7] = new Array(gas_form.contact_name, "Please enter the contact's name.");
	blank_check[8] = new Array(gas_form.phone, 'Please enter a phone number.');
	blank_check[9] = new Array(gas_form.email, 'Please enter your email address.');
	blank_check[10] = new Array(gas_form.years_in_business, 'Please enter the number of years in business.');
	blank_check[11] = new Array(gas_form.years_at_location, 'Please enter the number of years at this location.');
	blank_check[12] = new Array(gas_form.insurance_company, 'Please enter your current insurance provider.');
	blank_check[13] = new Array(gas_form.hours_of_operation, 'Please enter the hours of operation.');
	blank_check[14] = new Array(gas_form.liquor_sales, 'Please enter the number of liquor sales.');
	blank_check[15] = new Array(gas_form.mini_mart_sales, 'Please enter the number of mini mart sales.');
	blank_check[16] = new Array(gas_form.gasoline_sold, 'Please enter the number of gallons of gasoline sold.');
	blank_check[17] = new Array(gas_form.repair_sales, 'Please enter general auto repair sales.');
	blank_check[18] = new Array(gas_form.employees, 'Please enter the number of employees.');
	blank_check[19] = new Array(gas_form.payroll, 'Please enter the payroll.');
	blank_check[20] = new Array(gas_form.propane_sales, 'Please enter the propane sales.');
	
	for (j = 0; j < blank_check.length; j++)	{
		//check to see if the field is blank
		if (blank_check[j][0].value == "") {
			alert(blank_check[j][1])
			blank_check[j][0].focus()
			blank_check[j][0].select()
			return false
		}	
	}
	
	if (gas_form.mailing_state.value == "select_state") {
        alert("Please enter the state where the mailing address is located.")
		gas_form.mailing_state.focus()
		//gas_form.practice_state.select()
		return false
	}		
	
	if (!validZip(gas_form.mailing_zip.value)) {
		alert("You must enter a valid zip code.")
		gas_form.mailing_zip.focus()
		gas_form.mailing_zip.select()
		return false
	}		
	
	if (gas_form.location_state.value == "select_state") {
        alert("Please enter the state where the location address is located.")
		gas_form.location_state.focus()
		//gas_form.practice_state.select()
		return false
	}		

	if (!validZip(gas_form.location_zip.value)) {
		alert("You must enter a valid zip code.")
		gas_form.location_zip.focus()
		gas_form.location_zip.select()
		return false
	}	

	if (!validPhone(gas_form.phone.value)) {
		alert("You must enter a valid phone number.")
		gas_form.phone.focus()
		gas_form.phone.select()
		return false
	}	
	if (gas_form.fax.value !== "" && !validPhone(gas_form.fax.value)) {
        alert("Please enter a valid fax number.")
		gas_form.fax.focus()
		gas_form.fax.select()
		return false		
	} 	
	
	if (!validEmail(gas_form.email.value)) {
		alert("You must enter a valid email address.")
		gas_form.email.focus()
		gas_form.email.select()
		return false
	}	
		
	if (gas_form.insurance_company_expiration_month.value == "month" || gas_form.insurance_company_expiration_day.value == "day" || gas_form.insurance_company_expiration_year.value == "year") {
		
		if (gas_form.insurance_company_expiration_month.value == "month")	{
			alert("Please provide the month of the current insurance provider's expiration date.")
			gas_form.insurance_company_expiration_month.focus()
		} else if (gas_form.insurance_company_expiration_day.value == "day")	{
			alert("Please provide the day of the current insurance provider's expiration date.")
			gas_form.insurance_company_expiration_day.focus()
		} else if (gas_form.insurance_company_expiration_year.value == "year")	{
			alert("Please provide the year of the current insurance provider's expiration date.")
			gas_form.insurance_company_expiration_year.focus()
		} else	{
			alert("Please fill in the current insurance provider's expiration date.")
		}
		
		//gas_form.practice_state.select()
		return false
	}		
	
//Numeric Check
	var numeric_check = new Array();
	//numeric_check[0] = gas_form.years_in_business;
	//numeric_check[1] = gas_form.years_at_location;
	numeric_check[0] = gas_form.tax_id_1;
	numeric_check[1] = gas_form.tax_id_2;
	numeric_check[2] = gas_form.liquor_sales;
	numeric_check[3] = gas_form.mini_mart_sales;
	numeric_check[4] = gas_form.car_wash_sales;
	numeric_check[5] = gas_form.gasoline_sold;
	numeric_check[6] = gas_form.repair_sales;
	numeric_check[7] = gas_form.employees;
	numeric_check[8] = gas_form.propane_sales;
	numeric_check[9] = gas_form.square_footage;
	//numeric_check[12] = gas_form.building_age;
	numeric_check[10] = gas_form.contents;
	numeric_check[11] = gas_form.canopy;
	numeric_check[12] = gas_form.gasoline;
	numeric_check[13] = gas_form.car_wash;
	numeric_check[14] = gas_form.hozes_and_nozzles;
	numeric_check[15] = gas_form.pumps;
	numeric_check[17] = gas_form.liability_limits;
	numeric_check[18] = gas_form.liquor_liability;
	
	for (j = 0; j < numeric_check.length; j++)	{
		//check to see if the field is numeric
		if (numeric_check[j].value !== "" && !isNumeric(numeric_check[j].value)) {
			alert("Please enter a valid number.")
			numeric_check[j].focus()
			numeric_check[j].select()
			return false
		}	
	}

		
}	



// Check zip
function validZip(zip) {
		invalidChars = ":,;`~!@#$%^&*()_=[]{}\|/<>.+abcdefghigklmnopqrstuvwxyz"
		// check for bad charcters
		for (i=0; i < invalidChars.length; i++) {
		 	// does it contain any invalid characters?
			badChar = invalidChars.charAt(i)
			if (zip.indexOf(badChar,0) > -1) {
				return false
			}
		}
		// at least 5 characters
		if (zip.length < 5)	{
			return false
		}
		return true;
	}
// Check phone
function validPhone(phone) {
		invalidChars = ":,;`~!@#$%^&*_=[]{}\|/<>.+abcdefghigklmnopqrstuvwxyz"
		// check for bad charcters
		for (i=0; i < invalidChars.length; i++) {
		 	// does it contain any invalid characters?
			badChar = invalidChars.charAt(i)
			if (phone.indexOf(badChar,0) > -1) {
				return false
			}
		}
		// at least 9 characters
		if (phone.length < 9)	{
			return false
		}
		return true;
	}
// Check if it's numeric
function isNumeric(number) {
		invalidChars = ":();`~!@#$%^&*_=[]{}\|/<>-+abcdefghigklmnopqrstuvwxyz"
		// check for bad charcters
		for (i=0; i < invalidChars.length; i++) {
		 	// does it contain any invalid characters?
			badChar = invalidChars.charAt(i)
			if (number.indexOf(badChar,0) > -1) {
				return false
			}
		}
		return true;
	}	
// Check email address
function validEmail(email) {
		invalidChars = " /:,;"

		for (i=0; i < invalidChars.length; i++) {
		 	// does it contain any invalid characters?
			badChar = invalidChars.charAt(i)
			if (email.indexOf(badChar,0) > -1) {
				return false
			}
		}
		atPos = email.indexOf("@",1)
		// there must be one "@" symbol
		if (atPos == -1) {
			return false
		}
		if (email.indexOf("@",atPos+1) != -1) {
			// and only one "@" symbol
			return false
		}
		periodPos = email.indexOf(".",atPos)
		if (periodPos == -1) {
			// and at least one "." after the "@"
			return false
		}
		if (periodPos + 3 > email.length)	{
			// must be at least 2 characters after the "."
			return false
		}
		return true;
	}