Hi,
It would make life much easier for all of us if you tell us WHERE the parse error should be (It is in the error you get) and pointing us to that line.
I suppose this is the problem:
$query = "insert into customers values
('".$name."', '".$last."', '".$email."', '".$address."', '".$city."', '".$zip."', '".$state."', '".$phone."', '".$dob."')";
There is just way too many quotes in it, as far as I can tell.'
try:
$query = "insert into customers values
('$name', '$last', '$email', '$address', '$city', '$zip', '$state', '$phone', '$dob')";
I'd also suggest to use a full insert command, which will prevent you from inserting in the wrong colums:
$query = "insert into customers (name, last, email, address, city, zip, state, phone, dob) values
('$name', '$last', '$email', '$address', '$city', '$zip', '$state', '$phone', '$dob')";
<This is assuming the colum names correspond to the variable names.>
J.