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GalinaSmithAsked on April 18, 2016 at 8:40 AM
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BenReplied on April 18, 2016 at 8:46 AM
This should be the form: http://www.jotformpro.com/form/61023632900948 but please do let us know more details about the issue that you have since giving it a quick look it seems to be OK.
Once we know more we will be happy to assist with the same.