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Jason-Leizer-Photography-v3

Site Customization

Contact

<center>
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<table style="text-align:left;" cellpadding="2" cellspacing="0" border="0" bgcolor="transparent">
<tr>
<td style="" colspan="2">
<font face="Verdana" size="2" color="#fff"><b style="font-size:20px;">Contact Jason at 289-244-5222 jleizer@rogers.com</b><br />
<br /></font>
</td>
</tr>
<tr valign="top">
<td id="td_element_label_0" style="" align="">
<font face="Verdana" size="2" color="#fff"><b>Name</b></font> <span style="color:red;"><small>*</small></span>
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<tr>
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<tr valign="top">
<td id="td_element_label_1" style="" align="">
<font face="Verdana" size="2" color="#fff"><b>Email</b></font> <span style="color:red;"><small>*</small></span>
</td>
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<tr>
<td id="td_element_field_1" style="">
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<div style="padding-bottom:8px;color:#fff;"></div>
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<tr valign="top">
<td id="td_element_label_2" style="" align="">
<font face="Verdana" size="2" color="#fff"><b>Phone</b></font>
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<tr>
<td id="td_element_field_2" style="">
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<td style='padding-left:0px;'>
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<font face="Verdana" size="2" color="#fff">###</font>
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<td style='padding-top:5px;padding-left:3px;' valign='top'>
<font face="Verdana" size="2" color="#fff">-</font>
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<td style='padding-left:3px;'>
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<font face="Verdana" size="2" color="#fff">###</font>
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<td style='padding-top:5px;padding-left:3px;' valign='top'>
<font face="Verdana" size="2" color="#fff">-</font>
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<td style='padding-left:3px;'>
<input maxlength='4' style='width:40px;' value='' id='element_2_3' name='element_2[]' type='text' class='validate[optional,custom[onlyNumber],length[4,4]]' /><br />
<font face="Verdana" size="2" color="#fff">####</font>
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<div style="padding-bottom:8px;color:#fff;"></div>
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<tr valign="top">
<td id="td_element_label_3" style="" align="">
<font face="Verdana" size="2" color="#fff"><b>Subject</b></font> <span style="color:red;"><small>*</small></span>
</td>
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<tr>
<td id="td_element_field_3" style="">
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<tr valign="top">
<td id="td_element_label_4" style="" align="">
<font face="Verdana" size="2" color="#fff"><b>Message</b></font> <span style="color:red;"><small>*</small></span>
</td>
</tr>
<tr>
<td id="td_element_field_4" style="">
<textarea id="element_4" name="element_4" cols="60" rows="10" class="validate[required]">
</textarea>
<div style="padding-bottom:8px;color:#fff;"></div>
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<td colspan="2" align="right">
<input name="element_counts" value="5" type="hidden" /> <input name="embed" value="forms" type="hidden" /><input value="Send email" type="submit" /><input value="Clear" type="reset" />
</td>
</tr>
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</form>
</center>

Contact Jason at 289-244-5222 jleizer@rogers.com

Name *

Email *

Phone

###

-

###

-

####

Subject *

Message *

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