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<div id="txt_131" style="position: absolute; left: 678px; top: 262px; width: 66px; height: 16px; overflow: hidden;">
<p class="Wp-Body-P"><label for="edit_14"><span class="Body-C">Last name</span></label></p>
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<input id="edit_14" style="position: absolute; left: 788px; top: 262px; width: 152px;" maxlength="50" name="SURNAME" type="text" value="" />
<div id="txt_1" style="position: absolute; left: 678px; top: 292px; width: 94px; height: 16px; overflow: hidden;">
<p class="Wp-Body-P"><label for="edit_2"><span class="Body-C">E-mail Address</span></label></p>
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<input id="edit_2" style="position: absolute; left: 788px; top: 292px; width: 153px;" maxlength="100" name="EMAIL" type="text" value="" />
<div id="txt_3" style="position: absolute; left: 678px; top: 322px; width: 68px; height: 16px; overflow: hidden;">
<p class="Wp-Body-P"><label for="text_1"><span class="Body-C">Comments</span></label></p>
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<textarea id="text_1" style="position: absolute; left: 788px; top: 322px; width: 152px; height: 86px;" cols="16" name="COMMENT" rows="5"></textarea>
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<p class="Wp-Body-P"><label for="edit_16"><span class="Body-C">captcha</span></label></p>
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<div style="position: absolute; left: 760px; top: 413px; width: 190px; height: 69px;"><img src="http://www.serifwebresources.com/util/img_verify.php?gen_word=1" alt="" /><br /><input id="edit_16" name="captcha" size="20" type="text" /> <a title="Listen to audio CAPTCHA" href="http://www.serifwebresources.com/util/audio/audio.php?lang="><img style="vertical-align: middle;" src="http://www.serifwebresources.com/media/icons/audio-desc.png" alt="Listen to audio CAPTCHA" border="0" /></a></div>
<input id="butn_1" style="position: absolute; left: 678px; top: 493px; width: 81px; height: 22px;" type="submit" value="Submit" /> <input id="butn_2" style="position: absolute; left: 767px; top: 493px; width: 76px; height: 22px;" type="reset" value="Reset" /></form><img id="txt_169" style="position: absolute; left: 680px; top: 176px;" title="" src="wpimages/wpdba2a718_06.png" alt="Contact US " width="265" height="43" border="0" />
<div id="art_2" style="position: absolute; left: 368px; top: 408px; width: 100px; height: 51px;">
<div class="Wp-Heading-1-P"><span class="Heading-1-C">Emails<br /></span></div>
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<div id="txt_246" style="position: absolute; left: 368px; top: 346px; width: 257px; height: 51px; overflow: hidden;">
<p class="Wp-Body-P"><span class="Body-C">(914) 363-4798(Advent Message Radio)</span></p>
<p class="Wp-Body-P"><span class="Body-C">(646)&nbsp;240&nbsp;3292&nbsp;&nbsp;(Pastor Isaac Lewin)</span></p>
<p class="Wp-Body-P"><span class="Body-C">(914) 363 4038&nbsp;&nbsp;&nbsp;(Fax)</span></p>
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Creat By MiNi SheLL
Email: devilkiller@gmail.com