Enter To Win

Please ensure the information is complete so that your request can be addressed with efficiency. * Required fields.

Enter To Win Information
     
Your Personal Details You will win one of these draw gifts below:
     
First Name
*
42 Inch LCD TV 42 inch LCD TV
1500 Dollars Cash 1500 cash
7 Nights in Florida (Accommodations for 2 adults, airfare and food not included).

us

17 laptop (Retail Value $1000.00 CDN, Toshiba, Acer or HP). Alaska
$1000 Furniture Gift Certificate $1000 Furniture Gift Certificate
   
Last Name
   
Marital Status
   
Annual Income:
   
Home Phone
*
   
E-mail
   
Country
   
Province/State/Region
   
City
   
Street Address
 
Postal Code
 
   
Date of Birth
 
Are you available weekdays or weekends ? *
 
Terms and Conditions
 

* In order for this form to be submitted, please accept the following terms and conditions below:

* Serving Toronto and the GTA

* You must attend a 90 minute presentation: No obligation to purchase.

* 1 of 5 draw prizes will be awarded after the 90 minute presentation.

* One draw prize per couple will be awarded.

You are being given the opportunity to participate in a promotional offer without the obligation to purchase or join anything. Those who have previously participated in any promotion by Premium Buyers Club and their immediate relatives are not eligible for this draw. We are concerned about the protection of your personal information. We will be responsible for the personal information under our control. You have consented to personal information being disclosed herein and you understand how your personal information will be used by us to contact you for follow up purposes. The personal information is only being collected for the use by us and our affiliated companies. We will protect your personal information using normal appropriate security measures. We will only release the personal information to you on written request.


I agree to the terms and conditions