| First 
      Name:   
 | Last 
      Name:   
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    | E-Mail 
      Address:   
 | Company:   
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    | Address:   
 | Address 
      2: 
 | 
  
    | City:   
 | Zip/Postal Code:   
 | 
  
    | Country:   
 | Phone:  (example: 602-968-2818) 
 | 
        
        
  
    | Primary Business/Industry:   
 | Position:   
 | 
        
  
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    | Interest: 
 | Our Contact Details: 
                
        
          | Universal Solutions S.A.E. Tel: +202 785 0023, Fax: +202 5918 044
 Email: info@oilegypt.com
 |  |