Need Web Form Test

Greetings to all!

I’ve got a problem. I’m using a form to collect information from web site users, and the site stats show a 60% failure. I successfully send form submission through it EVERY TIME. The customer is dissatisfied with the number of submissions saying that they are markedly fewer than they have received in the past. I cannot confirm this.

I need some test form submissions on:
http://www.hellsbayboatworks.com/request/request.htm

Please put test time in the name block.

Ifthis form fails, please post with the OS/Browser that you’re using and the error you’re getting.

Thanks!