185445 simple form help

Hello i have a form i use on many of my websites and they work fine with no problems on my server. I now have a customer i'm doing work for him on another server so i uploaded the form to his website and nothing works. I'm not sure if his server doesn't allow something i have, or if my username and password i'm using is not correct (they tell me it is) but the script does nothing. I'm sure it's something easy that is just beyond me. I need help asap. Thanks. Josh check [login to view URL] to see the form.