<?
 
$email = "batman@batman.com";
$first_name = "batman";
$last_name = "batman";
$phone = "343434343343";
//http://app4.intellicontact.com/icp/signup.pl?listid=41249&specialid:41249=CHVM&reallistid=1&fields_email=addy@batman.com&fields_fname=addy&fields_lname=3232
 
 
 
 
$sendic = array('fields_email'=>$email,
        'fields_fname'=>$first_name,
        'fields_lname'=>$last_name,
        'fields_phone'=>$phone,
        'fields_address1'=>$address,
        'fields_city'=>$city,
        'fields_state'=> $state,
        'fields_zip'=>$zip,
        'fields_custom1'=>$custom1,
        'fields_custom2'=>$custom2,
        'listid'=>'43413',
        'specialid:43413'=>'NMOT',
        'clientid'=>'238661',
        'realistid'=>'1',
        'doubleopt'=>'0',
        'redirect'=>'none',
        'errorredirect'=>'none');
$url = 'http://app.intellicontact.com/icp/signup.php';
$ch = curl_init();
curl_setopt($ch, CURLOPT_URL, $url);
curl_setopt($ch, CURLOPT_POST, 1);
curl_setopt($ch, CURLOPT_POSTFIELDS, $sendic);
$result = curl_exec($ch);
curl_close($ch);
echo $result;
 
?>