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* required fields
name: * postal code:
address: phone:
city: fax:
province: email: *

questions and comments: *
Enter the security code below: *

Guess the letters and numbers
(passphrase riddle)
--
((??? - 2) - 10) = -5
&
small 'D' +2 letters
-
small 'S' +1 letters
and not a
"R",
but
't'
and not a
"R",
but
small 'E' +3 letters
-