Your Full Name
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Email
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Phone
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Organization
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Relation to Organization
*
Giveaway Item
*
How Do You Want The Winner To Contact You?
*
Go In The Business
Call
Other (explain in the text box below)
Midland-wide Consolation Prize or Special Announcement - Post Giveaway to get more people in your business.
Giveaway Month (Giveaway will happen the first week of month chosen)
*
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Giveaway Image (Business logo is used if no image is given)
.png, .jpeg, .jpg
Any Additional Details (If you answered "Other" above, please tell me how the winner can contact you to redeem the giveaway.)
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