//I changed the variables but I couldnt get it to work. Here is the form that I need to send
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<title>Untitled Document</title>
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<center>
<form name="filmdisc_club" method="post" action="club_subscription.php">
<table width="478" height="187" border="0" cellpadding="0" cellspacing="0">
<tr>
<td width="112" height="22" align="right">Name:</td>
<td colspan="5" align="left"><input name="Name" type="text"> </td>
</tr>
<tr>
<td align="right" height="22">Company Name:</td>
<td colspan="5"><input name="Company" type="text" size="45"></td>
</tr>
<tr>
<td align="right" height="15">Address:</td>
<td colspan="5"><input name="Address" type="text" size="45"></td>
</tr>
<tr>
<td align="right" height="15">City:</td>
<td width="144"><input type="text" name="City"></td>
<td width="34" align="right">State:</td>
<td width="55"><input name="State" type="text" size="2" maxlength="2"></td>
<td width="23" align="right">Zip:</td>
<td width="110"><input name="Zip" type="text" size="9" maxlength="10"></td>
</tr>
<tr>
<td align="right" height="15">Phone Number:</td>
<td colspan="5"><input name="Phone" type="text" size="12" maxlength="12"></td>
</tr>
<tr>
<td align="right" height="15">Email Address:</td>
<td colspan="5"><input name="Email" type="text" size="45"></td>
</tr>
</table>
<table width="478" height="15" border="0" cellpadding="0" cellspacing="0">
<tr>
<td width="107" align="right">Shipping:</td>
<td width="30" align="right"> </td>
<td width="296" align="left"><p>
<label>
<input type="radio" name="shipping" value="radio">
Overnight</label>
<br>
<label>
<input type="radio" name="shipping" value="radio" checked>
Standard</label>
<br>
</p></td>
<td width="9" align="right">:</td>
<td width="36"> </td>
</tr>
</table>
<p> </p><table width="991" height="152" border="0" cellpadding="0" cellspacing="0">
<tr>
<td width="247" height="23"><input name="aerials" type="checkbox" id="aerials" value="checkbox">
<a href="
http://www.filmdisc.com/sub_index/ae_vol1.html" target="_blank">Aerials</a></td>
<td width="191" height="23"><input name="backgrounds" type="checkbox" id="backgrounds" value="checkbox">
<a href="
http://www.filmdisc.com/sub_index/an_vol1.html" target="_blank">Backgrounds</a></td>
<td width="247" height="23"><input name="born_to_be_wild" type="checkbox" id="born_to_be_wild" value="checkbox">
<a href="
http://www.filmdisc.com/sub_index/bw_vol1.html" target="_blank">Born to be Wild</a></td>
<td height="23" colspan="3"><input name="business_day" type="checkbox" id="business_day" value="checkbox">
<a href="
http://www.filmdisc.com/sub_index/bd_vol1.html" target="_blank">Business Day</a></td>
</tr>
<tr>
<td height="23" ><input name="city_movement" type="checkbox" id="city_movement" value="checkbox">
<a href="
http://www.filmdisc.com/sub_index/cm_vol1.html" target="_blank">City Movement</a></td>
<td height="23"><input name="city_scape" type="checkbox" id="city_scape" value="checkbox">
<a href="
http://www.filmdisc.com/sub_index/cs_vol1.html" target="_blank">City Scape</a></td>
<td height="23"><input name="corporate_espionage" type="checkbox" id="corporate_espionage" value="checkbox">
<a href="
http://www.filmdisc.com/sub_index/ce_vol1.html" target="_blank">Corporate Espionage</a></td>
<td height="23" colspan="3"><input name="earthly_views" type="checkbox" id="earthly_views" value="checkbox">
<a href="
http://www.filmdisc.com/sub_index/ev_vol1.html" target="_blank">Earthly Views</a></td>
</tr>
<tr>
<td height="23"><input name="equestrian" type="checkbox" id="equestrian" value="checkbox">
<a href="
http://www.filmdisc.com/sub_index/eq_vol1.html" target="_blank">Equuestrian</a> </td>
<td><input name="exercise_&_fitness" type="checkbox" id="exercise_&_fitness" value="checkbox">
<a href="
http://www.filmdisc.com/sub_index/ef_vol1.html" target="_blank">Exercise & Fitness </a></td>
<td><input name="eyes" type="checkbox" id="eyes" value="checkbox">
<a href="
http://www.filmdisc.com/sub_index/ey_vol1.html" target="_blank">Eyes </a></td>
<td colspan="3"><input name="faces" type="checkbox" id="faces" value="checkbox">
<a href="
http://www.filmdisc.com/sub_index/fs_vol1.html" target="_blank">Faces </a></td>
</tr>
<tr>
<td height="23"><input name="family" type="checkbox" id="family" value="checkbox">
<a href="
http://www.filmdisc.com/sub_index/fa_vol1.html" target="_blank">Family</a></td>
<td><input name="feet" type="checkbox" id="feet" value="checkbox">
<a href="
http://www.filmdisc.com/sub_index/fe_vol1.html" target="_blank">Feet </a></td>
<td><input name="gardening" type="checkbox" id="gardening" value="checkbox">
<a href="
http://www.filmdisc.com/sub_index/ga_vol1.html" target="_blank">Gardening </a></td>
<td colspan="3"><input name="home_office" type="checkbox" id="home_office" value="checkbox">
<a href="
http://www.filmdisc.com/sub_index/ho_vol1.html" target="_blank">Home Office</a> </td>
</tr>
<tr>
<td height="23"><input name="kids_1" type="checkbox" id="kids_1" value="checkbox">
<a href="
http://www.filmdisc.com/sub_index/kids_vol1.html" target="_blank">Kids Vol 1 </a></td>
<td><input name="Kids_2" type="checkbox" id="Kids_2" value="checkbox">
<a href="
http://www.filmdisc.com/sub_index/kd_vol2.html" target="_blank">Kids Vol 2 </a></td>
<td><input name="kids_3" type="checkbox" id="kids_3" value="checkbox">
<a href="
http://www.filmdisc.com/sub_index/kd_vol3.html" target="_blank">Kids Vol 3 </a></td>
<td colspan="3"><input name="kids_4" type="checkbox" id="kids_4" value="checkbox">
<a href="
http://www.filmdisc.com/sub_index/kd_vol4.html" target="_blank">Kids Vol 4 </a></td>
</tr>
<tr>
<td height="23"><input name="life_happens" type="checkbox" id="life_happens" value="checkbox">
<a href="
http://www.filmdisc.com/sub_index/lh_vol1.html" target="_blank">Life Happens </a></td>
<td><input name="meeting_of_the_minds" type="checkbox" id="meeting_of_the_minds" value="checkbox">
<a href="
http://www.filmdisc.com/sub_index/mm_vol1.html" target="_blank">Meeting of the Minds</a> </td>
<td><input name="native_americans" type="checkbox" id="native_americans" value="checkbox">
<a href="
http://www.filmdisc.com/sub_index/na_vol1.html" target="_blank">Native Americans</a></td>
<td colspan="3"><input name="new_york_city" type="checkbox" id="new_york_city" value="checkbox">
<a href="
http://www.filmdisc.com/sub_index/ny_vol1.html" target="_blank">New York City</a> </td>
</tr>
<tr>
<td height="23"><input name="pets" type="checkbox" id="pets" value="checkbox">
<a href="
http://www.filmdisc.com/sub_index/pt_vol1.html" target="_blank">Pets </a></td>
<td><input name="romance_1" type="checkbox" id="romance_1" value="checkbox">
<a href="
http://www.filmdisc.com/sub_index/rm_vol1.html" target="_blank">Romance Vol 1</a> </td>
<td><input name="romance_2" type="checkbox" id="romance_2" value="checkbox">
<a href="
http://www.filmdisc.com/sub_index/rm_vol2.html" target="_blank">Romance Vol 2</a></td>
<td colspan="3"><input name="san_francisco" type="checkbox" id="san_francisco" value="checkbox">
<a href="
http://www.filmdisc.com/sub_index/sf_vol1.html" target="_blank">San Francisco</a></td>
</tr>
<tr>
<td height="23"><input name="seniors" type="checkbox" id="seniors" value="checkbox">
<a href="
http://www.filmdisc.com/sub_index/sr_vol1.html" target="_blank">Seniors</a></td>
<td><input name="serenity" type="checkbox" id="serenity" value="checkbox">
<a href="
http://www.filmdisc.com/sub_index/sy_vol1.html" target="_blank">Serenity</a></td>
<td><input name="shoot_&_aim" type="checkbox" id="shoot_&_aim" value="checkbox">
<a href="
http://www.filmdisc.com/sub_index/sh_vol1.html" target="_blank">Shoot & Aim</a></td>
<td colspan="3"><input name="shuttle_launch" type="checkbox" id="shuttle_launch" value="checkbox">
<a href="
http://www.filmdisc.com/sub_index/sl_vol1.html" target="_blank">Shuttle Launch</a></td>
</tr>
<tr>
<td height="23"><input name="sillhouette" type="checkbox" id="sillhouette" value="checkbox">
<a href="
http://www.filmdisc.com/sub_index/si_vol1.html" target="_blank">Sillhouette</a></td>
<td><input name="skate_&_snow" type="checkbox" id="skate_&_snow" value="checkbox">
<a href="
http://www.filmdisc.com/sub_index/ss_vol1.html" target="_blank">Skate & Snow</a></td>
<td><input name="sports" type="checkbox" id="sports" value="checkbox">
<a href="
http://www.filmdisc.com/sub_index/sp_vol1.html" target="_blank">Sports</a></td>
<td width="250"><input name="spring_cleaning" type="checkbox" id="spring_cleaning" value="checkbox">
<a href="
http://www.filmdisc.com/sub_index/sc_vol1.html" target="_blank">Spring Cleaning</a></td>
</tr>
<tr>
<td height="23"><input name="stars_&_stripes" type="checkbox" id="stars_&_stripes" value="checkbox">
<a href="
http://www.filmdisc.com/sub_index/st_vol1.html" target="_blank">Stars & Stripes</a></td>
<td><input name="sunsets" type="checkbox" id="sunsets" value="checkbox">
<a href="
http://www.filmdisc.com/sub_index/su_vol1.html" target="_blank">Sunsets</a></td>
<td><input name="the_love_of_the_game" type="checkbox" id="the_love_of_the_game" value="checkbox">
<a href="
http://www.filmdisc.com/sub_index/tl_vol1.html" target="_blank">The Love of the Game</a></td>
<td colspan="2"><input name="transportation" type="checkbox" id="transportation" value="checkbox">
<a href="
http://www.filmdisc.com/sub_index/tr_vol1.html" target="_blank">Transportation</a></td>
</tr>
<tr>
<td height="23"><input name="underwater_life" type="checkbox" id="underwater_life" value="checkbox">
<a href="
http://www.filmdisc.com/sub_index/ul_vol1.html" target="_blank">Underwater Life</a></td>
<td><input name="venice" type="checkbox" id="venice" value="checkbox">
<a href="
http://www.filmdisc.com/sub_index/ve_vol1.html" target="_blank">Venice</a></td>
<td><input name="venice_waterways" type="checkbox" id="venice_waterways" value="checkbox">
<a href="
http://www.filmdisc.com/sub_index/vw_vol1.html" target="_blank">Venice Waterways</a></td>
<td><input name="young_couples_1" type="checkbox" id="young_couples_1" value="checkbox">
<a href="
http://www.filmdisc.com/sub_index/yc_vol1.html" target="_blank">Young Couples Vol 1</a></td>
</tr>
<tr>
<td height="23"><input name="young_couples_2" type="checkbox" id="young_couples_2" value="checkbox">
<a href="
http://www.filmdisc.com/sub_index/yc_vol2.html" target="_blank">Young Couples Vol 2</a></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr>
<td height="23" align="right"> </td>
<td>
</td>
<td>
</td>
</tr>
</table>
<input type="submit" name="Submit" value="Submit">
<input type="reset" name="Reset" value="Clear Form">
</form>
</center>
</body>
</html>