Contest Form

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First Name *

Last Name *

City *

State *    Select  your  state  AL AK AS AZ AR CA CO CT DE DC FL GA HI ID IL IN IA CS KY LA ME MD MA MI MN MS MO MT NE MV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY

Email Address .

Phone # (10 digits) * Winners will be contacted by phone.

Age *

• 21 - 24
• 25 - 35
• 36 - 50
• 51 - 70
• 71+

Marital Status *

• Married
• Single
• Partner

Household Income *

• $0 - $39,999
• $40,000 - $49,999
• $50,000 - $69,999
• $70,000+

Contest Rules *

• I agree with the contest rules

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Sign Up Today to Win this Season's Big Prizes!!
The Worcester Sharks and Steele Hill are bringing you great prizes for the 2011-2012 season. Enter now for your chance to win!!

Grand Prize:

• 7 Nights Luxury accommodations
• Round Trip Airfare for 4
• 4 Tickets to Disney
• 4 Tickets to Universal Studios

2nd Runner Up: Orlando Getaway

• 7 Nights luxury Family Accommodations in Orlando

3rd Runner Up: New England Escape

• 4 Nights at Steele Hill Resorts Located in New Hampshire's Lakes and Mountains region

Special Prize:
Official Autographed Sharks Memorabilia Prize Pack!!

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