Contact Us
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<TD vAlign=top width="5%" height=50> </TD>
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<TD width=400><IMG id=Image1
alt="KLEEN-SCENTS 4512 E 51ST STREET, SUITE I TULSA, OK 74135 Phone:(918) 627-4006 (918) 972-3687 Fax: (877) 627-4094 Email: scents@kleen-scents.com "
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<P><FONT face=Arial size=3><BR>Or, send us your request on the form
below & we'll get back to you as soon as possible.</FONT></P><BR
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<FORM name=ContactUs
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method=post><INPUT id=Redirect_URL type=hidden
value=http://www.kleen-scents.com/default.asp
name=Redirect_URL> <INPUT id=MailToName type=hidden
value="Randolph Cain" name=MailToName> <INPUT id=MailToAddress
type=hidden value=scents@kleen-scents.com name=MailToAddress>
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<TR>
<TD><FONT face=Arial size=2><BR>Name
(Required):</FONT><BR><INPUT size=50
name=Request_Name></TD></TR>
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<TD><FONT face=Arial
size=2><BR>Address:</FONT><BR><INPUT size=50
name=Request_Address1><BR><INPUT size=50
name=Request_Address2></TD></TR>
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<TD>
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<TD><FONT face=Arial size=2><BR>City:</FONT></TD>
<TD><FONT face=Arial size=2><BR>State:</FONT></TD>
<TD><FONT face=Arial size=2><BR>Zip:</FONT></TD></TR>
<TR>
<TD><INPUT size=31 name=Request_City></TD>
<TD><INPUT size=5 name=Request_State></TD>
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<TD>
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<TD><FONT face=Arial size=2><BR>Phone:</FONT></TD>
<TD><FONT face=Arial size=2><BR>Fax:</FONT></TD></TR>
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<TD><FONT face=Arial size=2><BR>E-mail Address
(Required):</FONT><BR><INPUT size=50
name=Request_Email></TD></TR>
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<TD><FONT face=Arial
size=2><BR>Questions/Comments:</FONT><BR><TEXTAREA name=Request_Comments rows=7 cols=44></TEXTAREA></TD></TR>
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<TD id=WSCFooter vAlign=top align=middle colSpan=3><BR clear=all><!--footer--><A href="default.asp"><FONT face=Arial size=1>Home
Page</FONT></A><FONT face=Arial size=1> | </FONT><A
href="about.html"><FONT face=Arial size=1>About Us</FONT></A><FONT
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size=1>Fragrances Qt</FONT></A><FONT face=Arial
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face=Arial size=1>Mini-Scents Refills</FONT></A><FONT face=Arial
color=#000000 size=1> | </FONT><A
href="FrequentlyAskedQuestions.html"><FONT face=Arial size=1>Frequently
Asked Questions</FONT></A><FONT face=Arial color=#000000
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PayPal!</SPAN></FONT></TD></TR>
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