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WUXLY REQUEST FORM
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ORDER # *
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FULL NAME *
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DAYTIME PHONE # *
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PRODUCT DESCRIPTION: MODEL NAME, COLOUR, SIZE *
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WHAT STYLE, COLOUR, SIZE YOU WISH TO EXCHANGE FOR? (For exchanges only) *
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TYPE OF ISSUE/REPAIR (For repairs only)
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REASON FOR REQUEST *
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FULL SHIPPING ADDRESS *
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