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Default Email form with pop up box function

I would like to email a document as an attachment but give the user the
ability to enter in a number that the email will be sent to. Our MS exchange
users are categorized by numbers. For example once the user has completed the
form I would like them to be able to press a button, a pop up box appear
where they enter the numbers then press OK and the email will be sent to that
user with the attachment. Thanks for any info!
 
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