Text Field

[er12]

Hello
I have this form

http://chtremb.5u.com/tform.htm

I am trying to get a pop up window to open when I click "verify" to display the info entered in the fields and a submit and a review button. I am very much new at this and would appreciate any help. This is a text file with the html code for the page.

http://chtremb.5u.com/html.txt

Thanks you.