here
#DateFormat(now(), 'mm-dd-yyyy')#
#timeformat(now(), 'hh:mm t')#
#REMOTE_ADDR#
Name: #form.Name#
Email: #form.Email#
Phone1: #form.Phone1#
Phone2: Not Provided#form.Phone2# ext.#form.Ext#
Fax: Not Provided#form.Fax#
Address1: Not Provided#form.Address1#
Address2: Not Provided#form.Address2#
City: Not Provided#form.City#
State: Not Provided#form.State#
Zip: Not Provided#form.Zip1#-#form.Zip2#
URL to advertise: Not Provided#form.URL#
Comments: Not Provided#form.Comments#