3/50 Drawing Entry

First Name:

Last Name:

Email:

Thank you for entering the Chamber's monthly 3/50 Chamber Check drawing. To enter, fill out and submit this form indicating three Chamber member businesses that you support (Hint: If you are unsure if a business is a Chamber member, use the search or directory features at http://www.fyiLA.com to verify.)
Chamber Member 1:

Chamber Member 2:

Chamber Member 3:

Send me a once per month email with coupons and special offers from Los Alamos Chamber member businesses and organizations.:
	Yes No
Phone Number (so we can contact you when you win!):

The 3/50 Project is a grass roots campaign to raise the awareness of local residents about the importance of local businesses to our community. We encourage you to take the 3/50 challenge. Read more at http://www.the350project.net
Security Code:
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