Please use this form to send us your questions, general comments, pricing
requests, inquiries,
or anything else that comes to mind. We welcome all of your comments and
suggestions. Expect to receive a reply within three business days.
When you have completed the form, click the SUBMIT button.
Name
E-mail
Tel
FAX
Please contact me as soon as possible regarding this
matter.
<!-- Begin Freedback Form -->
<!-- DO NOT EDIT YOUR FORM HERE, PLEASE LOG IN AND EDIT AT FREEDBACK.COM -->
<form enctype="multipart/form-data" method="post" action="http://www.freedback.com/mail.php" accept-charset="UTF-8">
<div>
<input type="hidden" name="acctid" id="acctid" value="73w8bqlrqdkzfqp4" />
<input type="hidden" name="formid" id="formid" value="379113" />
<input type="hidden" name="required_vars" id="required_vars" value="name,email" />
</div>
<table cellspacing="5" cellpadding="5" border="0">
<tr>
<td valign="top">
<strong>Name:</strong>
</td>
<td valign="top">
<input type="text" name="name" id="name" size="40" value="" />
</td>
</tr>
<tr>
<td valign="top">
<strong>Email Address:</strong>
</td>
<td valign="top">
<input type="text" name="email" id="email" size="40" value="" />
</td>
</tr>
<tr>
<td colspan="2" align="center">
<input type="submit" value=" Submit Form " />
</td>
</tr>
</table>
</form>
<br><center><font face="Arial, Helvetica" size="1"><b>
<a href="http://www.freedback.com">form creator</a>
</b></font></center>
<!-- End Freedback Form -->
MAGNA-TECH ELECTRONIC CO., INC.
1998 NE 150th Street
North Miami, FL 33181 USA
Phone (305) 573-7339
Fax (305) 573-8101
