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Please complete the details below

*REQUIRED FIELDS

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Full Name: .

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Company .

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Phone Number .

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Qualifying Purchase Order Number: .

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Email: ..

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Name one item on your Bucket List:

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* X I have read and agree to the terms and conditions.

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Terms & Conditions 1. Any applicable taxes are the responsibility of the winner. 2. There will be 2 promotional periods as follows: ..........Period 1..........1 January 2013 to 31 March 2013 ..........Period 2..........1 April 2013 to 30 June 2013 3. Entries received during a promotional period will only be valid for that promotional period. 4. You may enter as many times as you like but each entry must be accompanied by a different Purchase Order number from an order that has been placed with Express Data during the applicable promotional period as identified in Term 2 above. 5. Express Data reserves the right to cancel or amend any aspect of this promotion without notice and at its absolute discretion. 6. Should there be a dispute for any reason, Express Data’s decision on the matter is final. 7. Prizes are not redeemable for cash. 8. By entering this competition, entrants confirm they have approval from their business owner/manager to participate in this promotion. 9. By entering this competition, you are agreeing to allow your name and/or image to be used in promotional material regarding this promotion.

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