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<td><strong><span style="color: #93908b; font-size: small;">Speak Up!</span></strong> * It is important for you to complete all fields so that we may best respond to your message.<br /><br />&nbsp;</td>
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<div><strong>Name</strong>:</div>
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<td><input id="name" name="name" size="40" type="text" /><br /></td>
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<div><strong>Email Address</strong>:</div>
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<td><input name="emailAddress" size="40" type="text" /><br /></td>
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<div><strong>Location</strong>:</div>
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<div><select name="SemailTo"> <option>Please Choose a Location</option> <option value="dfieramosca@grimaldispizzeria.com, egreenwald@grimaldispizzeria.com, cwhite@grimaldispizzeria.com, tfieramosca@grimaldispizzeria.com"> Chandler - The Falls at Ocotillo</option> <option value="bflory@grimaldispizzeria.com, dfieramosca@grimaldispizzeria.com, egreenwald@grimaldispizzeria.com, bfisher@grimaldispizzeria.com"> Corpus Christi - La Palmera</option> <option value="mkamsiuk@grimaldispizzeria.com, dfieramosca@grimaldispizzeria.com, egreenwald@grimaldispizzeria.com, cwhite@grimaldispizzeria.com, mkamsiuk@grimaldispizzeria.com"> North Scottsdale - Market Street at DC Ranch</option> <option value="ddrago@grimaldispizzeria.com, dfieramosca@grimaldispizzeria.com, egreenwald@grimaldispizzeria.com, cwhite@grimaldispizzeria.com"> Scottsdale - Old Town</option> <option value="bwhitehead@grimaldispizzeria.com, clattuca@grimaldispizzeria.com, dfieramosca@grimaldispizzeria.com, egreenwald@grimaldispizzeria.com, cwhite@grimaldispizzeria.com"> Scottsdale Quarter - Scottsdale</option> <option value="jborzone@grimaldispizzeria.com, dfieramosca@grimaldispizzeria.com, egreenwald@grimaldispizzeria.com, cwhite@grimaldispizzeria.com"> Gilbert - San Tan Village</option> <option value="rseidner@grimaldispizzeria.com, dfieramosca@grimaldispizzeria.com, egreenwald@grimaldispizzeria.com, cwhite@grimaldispizzeria.com"> Peoria - Park West</option> <option value="jspear@grimaldispizzeria.com, dfieramosca@grimaldispizzeria.com, egreenwald@grimaldispizzeria.com, cwhite@grimaldispizzeria.com"> Tucson - Sam Hughes Place</option> <option value="egreenwald@grimaldispizzeria.com, dfieramosca@grimaldispizzeria.com, ttierney@grimaldispizzeria.com,plawson@grimaldispizzeria.com"> Fort Meyers - Bell Tower</option> <option value="dfieramosca@grimaldispizzeria.com, egreenwald@grimaldispizzeria.com, jstubbs@grimaldispizzeria.com, clattuca@grimaldispizzeria.com, rmerlo@grimaldispizzeria.com"> Las Vegas - Rainbow</option> <option value="dfieramosca@grimaldispizzeria.com, egreenwald@grimaldispizzeria.com, jstubbs@grimaldispizzeria.com"> Las Vegas - Richmar Plaza</option> <option value="dfieramosca@grimaldispizzeria.com, egreenwald@grimaldispizzeria.com, fruiz@grimaldispizzeria.com"> Allen - Watters Creek</option> <option value="dfieramosca@grimaldispizzeria.com, egreenwald@grimaldispizzeria.com, fruiz@grimaldispizzeria.com, rleggett@grimaldispizzeria.com"> Dallas - West Village</option> <option value="dfieramosca@grimaldispizzeria.com, egreenwald@grimaldispizzeria.com, bfisher@grimaldispizzeria.com, mbuitron@grimaldispizzeria.com"> Houston - The Woodlands</option> <option value="dfieramosca@grimaldispizzeria.com, egreenwald@grimaldispizzeria.com, bfisher@grimaldispizzeria.com, amota@grimaldispizzeria.com"> San Antonio - La Cantera</option> <option value="dfieramosca@grimaldispizzeria.com, egreenwald@grimaldispizzeria.com, rcondell@grimaldispizzeria.com"> Sparks - Legends at Sparks Marina</option> <option value="pgibson@grimaldispizzeria.com, dfieramosca@grimaldispizzeria.com, egreenwald@grimaldispizzeria.com, bfisher@grimaldispizzeria.com"> Sugar Land - First Colony</option> <option value="dfieramosca@grimaldispizzeria.com, egreenwald@grimaldispizzeria.com, rmessley@grimaldispizzeria.com"> Summerlin - Boca Park</option> </select></div>
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<div><strong>City</strong>:</div>
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<div><select name="location"> <option>Please Choose a City</option> <option value="Chandler - The Falls at Ocotillo"> Chandler, AZ</option> <option value="Gilbert - San Tan Village"> Gilbert, AZ</option> <option value="North Scottsdale - Market Street at DC Ranch"> North Scottsdale, AZ</option> <option value="Peoria - Park West"> Peoria, AZ</option> <option value="Scottsdale - Old Town"> Scottsdale, AZ</option> <option value="Tucson - Sam Hughes Place"> Tucson, AZ</option> <option value="Fort Meyers - Bell Tower"> Fort Meyers, FL</option> <option value="Las Vegas - Boca Park"> Boca Park-Las Vegas, NV</option><option value="Las Vegas - Rainbow"> Rainbow-Las Vegas, NV</option> <option value="Las Vegas - Richmar Plaza"> Richmar-Las Vegas, NV</option> <option value="Sparks - Legends at Sparks Marina"> Sparks, NV</option> <option value="Summerlin - Boca Park"> Summerlin, NV</option> <option value="Allen - Watters Creek"> Allen, TX</option> <option value="Corpus Christi - La Palmera"> Corpus Christi, TX</option> <option value="Dallas - West Village"> Dallas, TX</option> <option value="Houston - The Woodlands"> Houston, TX</option> <option value="San Antonio - La Cantera"> San Antonio, TX</option> <option value="Sugar Land - First Colony"> Sugar Land, TX</option> </select></div>
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<div><strong>Category</strong>:</div>
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<div><select name="SemailCc"> <option>Please Choose a Category</option> <option value="CC: clattuca@grimaldispizzeria.com, lzeller@grimaldispizzeria.com"> Food and Beverage Experience</option> <option value="CC: clattuca@grimaldispizzeria.com, bmaroney@grimaldispizzeria.com, lzeller@grimaldispizzeria.com"> Dining Experience</option> <option value="CC: bmaroney@grimaldispizzeria.com, lzeller@grimaldispizzeria.com"> Web Site Suggestion </option> <option value="CC: bmaroney@grimaldispizzeria.com, lzeller@grimaldispizzeria.com"> Marketing Promotion </option> <option value="CC: bmaroney@grimaldispizzeria.com, lzeller@grimaldispizzeria.com"> Other </option> </select></div>
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<div><strong>Message</strong>:</div>
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<td><textarea id="message" cols="50" rows="4" name="message"></textarea></td>
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<td style="text-align: center;" colspan="2"><br /><input name="Submit" type="submit" value="Submit" /></td>
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