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<title>uknumber.co.uk - Giving you a free UK phone number - wherever you are in
the world!</title>
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                    <td><img border="0" src="logo.gif" width="380" height="47" align="left"></td>
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                    <p align="right"><i><b><font face="Tahoma,Verdana" size="3" color="#000080">Giving
                      you a </font><font face="Tahoma,Verdana" color="#FF0000" size="4">free</font><font face="Tahoma,Verdana" size="3" color="#000080">
                    UK phone number<br>
                    -
                    wherever you are in the world!</font></b></i></td>
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		<form method="POST" action="intnum.php">
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    					To complete your number allocation, please enter the following details for our records<br>(fields marked with <font color="red">*</font> are required):
    				</td></tr>
    				<tr><td colspan=2>&nbsp;</td></tr>
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                      <td width="30%"><font face="Tahoma,Verdana" size="2">First name:</font></td>
                      <td width="70%"><input type="text" name="firstname" size="50" maxlength="50"><font color="red">*</font></td>
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                      <td width="30%"><font face="Tahoma,Verdana" size="2">Surname:</font></td>
                      <td width="70%"><input type="text" name="surname" size="50" maxlength="50"><font color="red">*</font></td>
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                      <td width="30%"><font face="Tahoma,Verdana" size="2">Address 1:</font></td>
                      <td width="70%"><input type="text" name="address1" size="50 "maxlength="50"><font color="red">*</font></td>
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                      <td width="30%"><font face="Tahoma,Verdana" size="2">Address 2:</font></td>
                      <td width="70%"><input type="text" name="address2" size="50 "maxlength="50"></td>
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                      <td width="30%"><font face="Tahoma,Verdana" size="2">Town/City:</font></td>
                      <td width="70%"><input type="text" name="town" size="50 "maxlength="50"><font color="red">*</font></td>
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                      <td width="30%"><font face="Tahoma,Verdana" size="2">Postcode:</font></td>
                      <td width="70%"><input type="text" name="postcode" size="50 "maxlength="50"><font color="red">*</font></td>
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                      <td width="30%"><font face="Tahoma,Verdana" size="2">Country:</font></td>
                      <td width="70%"><input type="text" name="country" size="50 "maxlength="50"><font color="red">*</font></td>
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                      <td width="30%"><font face="Tahoma,Verdana" size="2">Your e-mail address:</font></td>
                      <td width="70%"><input type="text" name="emailaddr" size="50" maxlength="70"><font color="red">*</font></td>
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                      <td width="30%"><font face="Tahoma,Verdana" size="2">Your IP address is &nbsp;</font></td>
                      <td width="70%"><font face="Tahoma,Verdana" size="2"> 69.175.20.250</font></td>
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    				<tr><td colspan=2>&nbsp;</td></tr>
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                      <td width="70%" colspan=2><font face="Tahoma,Verdana" size="2">We may use the information you have provided and pass this data to telephone directory service providers.<br>&nbsp;&nbsp; Please tick this box if you don't wish this to happen &nbsp;<input type="checkbox" name="nodq"></font></td>
                      <td width="30%">&nbsp;</td>
    				</tr>
    				<tr><td colspan=2>&nbsp;</td></tr>
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 	                  <td width="100%" align="center" colspan=2><input type="submit" value="Click to get your number" size=30 style="font-family: Tahoma, Verdana; font-size: 10pt; font-style: italic; font-weight: bold"></td>
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					<input type=hidden name="gotaddress" value="1">
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<input type=hidden name="type" value=""><input type=hidden name="number" value=""><input type=hidden name="fax" value=""><input type=hidden name="voip" value=""><input type=hidden name="uk" value=""></form>

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			<center><a href="/"><b>Home</b></a></center>
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