// function inside a function
function form() {

$quote_info = ""
	. results($results['storage']) . "<br />"
	. results($results['bandwidth']) . "<br />"
	. results($results['domains']) . "<br />"
	. results($results['mysql']) . "<br />"
	. results($results['emails']) . "<br />"
	. results($results['ftp']) . "";


$form = '
	  <p>
	  <form action="includes/custom-web-mod-emailer.php" method="post">
	  <table width="80%" border="0" align="center">
  <tr>
    <td><b>Full Name:</b></td>
    <td><input type="text" name="full_name"/></td>
  </tr>
  <tr>
    <td><b>Email Address:</b></td>
    <td><input type="text" name="email_addy"/></td>
  </tr>
  <tr>
    <td><b>Phone Number:</b></td>
    <td><input type="text" name="phone_num"/></td>
  </tr>
  <tr>
    <td><b>Street  Address:</b></td>
    <td><input type="text" name="street_addy"/></td>
  </tr>
  <tr>
    <td><b>State:</b></td>
    <td><input type="text" name="state"/></td>
  </tr>
  <tr>
    <td><b>Country:</b></td>
    <td><input type="text" name="country"/></td>
  </tr>
  <tr>
    <td colspan="2" align="center">
	<input type="submit" name="form_submit" value="Request Quote" />&nbsp;&nbsp;&nbsp;<input type="reset" value="Clear Form" />&nbsp;&nbsp;&nbsp;<input type="button" name="cancel" value="Cancel" /></td>
  </tr>
</table>
	  </form>
	  </p>

';
return $form;
}