function validate(form){
  var name = form.Name.value;
  var email = form.Email.value;
  var address = form.Address.value;
  var city = form.City.value;
  var state = form.State.value;
  var zip = form.Zip.value;
  var auth = form.Auth.value;
  
 // var message = form.message.value;
  var nameRegex = /^[a-zA-Z]+(([\'\,\.\- ][a-zA-Z ])?[a-zA-Z]*)*$/;
  var emailRegex = /^[\w-\.]+@([\w-]+\.)+[\w-]{2,4}$/;
  var messageRegex = new RegExp(/<\/?\w+((\s+\w+(\s*=\s*(?:".*?"|'.*?'|[^'">\s]+))?)+\s*|\s*)\/?>/gim);
  
  for(i=0; i< form.elements.length; i++) {
	form.elements[i].style.backgroundColor='';
  }

  if(name == "") {
    inlineMsg('Name','You must enter your name.');
    return false;
  }
  if(email == "") {
    inlineMsg('Email','You must enter your email address.');
    return false;
  }
 
  if(address == "") {
    inlineMsg('Address','You must enter your addresss.');
    return false;
  }
 
  if(city == "") {
    inlineMsg('City','You must enter your city.');
    return false;
  }
 
   if(state == "") {
    inlineMsg('State','You must enter your state.');
    return false;
  } 
  
  if(zip == "") {
    inlineMsg('Zip','You must enter your zip code.');
    return false;
  }
  
  if(auth != "jivahealth" || auth == "") {
    inlineMsg('Auth','You must enter the correct characters');
    return false;
  }
  function inlineMsg(target,msg) {
  	document.getElementById(target).style.backgroundColor='#f4efb0';
	document.getElementById(target).focus();
	alert(msg);
  }
  return true;
}