Form for Critiques

<br><center><img src=http://31.media.tumblr.com/b6998cfc649da5023605ea38e52b91ab/tumblr_nelsh9bmDI1rrtza4o9_r1_500.gif width=300>
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<center> <b> <u> I WANT A CRITIQUE </b> </u>
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+ Name:
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+ Experience:
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+ Program: [used to make graphic ]
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+ Graphic:
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+ Talk About?: