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Staco Sine

Unique Code Number Request to Participate In 2008 Monthly Drawings

Please mail my 2008 Staco Energy Line Card with my unique code number, so I can come back and register to be eligible to win a $50 Gift Certificate in the 2008 monthly drawings.

* Required

*Your Name:

*Company:

*E-mail:

*Phone:

*Address 1:

Address 2:

*City:

*State/Province:

Country:

*ZIP/Postal Code:

*Fax:

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