HOTLINE request

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<h4 style="color:#A60900;font-size:6px">layout by jewel1307</h4>
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<img src="http://images.cooltext.com/4285864.png" style="height:80px;margin:-145px 0px 0px 170px"><br>
<a href="FORM LINK"><img src="http://i.imgur.com/6Bxd3ps.png" style="width:60px;margin:-138px 0px 0px 20px"></a>

<b> Name: </b>

<b> Code/Name you would like us to address you as: [optional] </b>

<b> Type(s) of the problem(s): </b>
<i>a) Relationships [Friends/Family/Partners/Boyfriends or Girlfriends] b) Personal Development [Puberty/Interests/Life Goals/Academics] c) Others [Please be specific. e.g. b) Personal Development: Academics]</i>

<b> Is it urgent?: </b>

<b> Do you allow us to post your problem, along with our answer on our magazine?: </b>

<b> Where do you want your answer to be posted?: [On the thread/inbox/both] </b>
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