$(document).ready(
	function() {
				
		$('#dyn_form_65').bind('submit', function() {
			
			var sErr = '';
			
									if ($("[name='data_element_19962']").val() == '')
						{
							sErr += '* Course\n';
						}
												if ($("[name='data_element_19957']").val() == '')
						{
							sErr += '* Preferred Dates\n';
						}
												if ($("[name='data_element_19958']").val() == '')
						{
							sErr += '* Name\n';
						}
												if ($("[name='data_element_19960']").val() == '')
						{
							sErr += '* Email Address\n';
						}
									
			if (sErr != '') {
				alert('Please complete the following fields:\n\n' + sErr);
				return false;
			}
			
			return true;
		});
	}
);