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<form action="https://webto.salesforce.com/servlet/servlet.WebToCase?encoding=UTF-8" method="POST">

  <input type="hidden" name="orgid" value="00D300000000Swd"/>
  <input type="hidden" name="retURL" value="http://support.companioncorp.com"/>

<input type="hidden" name="debug" value="1" />
<input type="hidden" name="debugEmail" value="mvoseipka@companioncorp.com"/>

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  <label for="email"><b>Email</b></label> <br /><input  id="email" maxlength="80" name="email" size="30" type="text" /><br /><br />

  <label for="phone"><b>Phone</b></label> <br /><input  id="phone" maxlength="40" name="phone" size="30" type="text" /><br /><br />

  <label for="subject"><b>Subject</b></label> <br /><input  id="subject" maxlength="80" name="subject" size="30" type="text" /><br /><br />

  <label for="description"><b>Description</b></label> <br /><textarea name="description" rows="10" cols="70"></textarea><br /><br />

  <input type="submit" name="submit"/>

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Do you have an idea or suggestion? We'd love to hear from you!