"") { $body = "ID: " . $firstname4 . $NL . "Permit: " . $firstname3 . $NL . "Company: " . $firstname2 . $NL . "Contact: " .$NL ." " . $firstname . " " . $lastname . $NL . " " . $address . $NL . " " . $city . ", " . $state . " "; $body = $body . $zip . $NL . " " . $country . $NL . $NL . "Phone: " . $phone . $NL . "Fax: " . $fax . $NL . "Stores: " . $email3 . $NL . "Website: " . $email2 . $NL . "E-mail: " . $email . $NL . "Message:" . $NL . $message; mail("partywrex@hotmail.com,wfb@netcr.com", "GrooveCity feedback information", $body, "From:webmaster@groovecity.com"); ?>

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Federal ID#
State Sales Tax Permit#
Company Name
Buyers First Name *
Last Name *
Address *
City *
State/Province/Region *
ZIP or Postal Code *
(If U.S., 5 digit ZIP only)
Phone Number *
Fax Number
E-mail Address *
Number of stores/outlets
Website
Description of business