Polished Image - Contest Entry Form

Contest Entry Form

From "Drab to Fab Entry Form"

Please fill out the following information and attach a photo of yourself with the submission.

Name: _____________________________________

Address: ___________________________________

City: _______________________________________

Postal Code: _________________________________

Phone Number (home): _____________ (work): __________

Email address: ________________________________

I am nominating (please circle one): Myself Someone else**

**(if you are nominating someone else, please fill in the information at the bottom of this form)

Gender of person being nominated (please circle one) M F

Age Range of person being nominated (please circle one):

20-25 26-30 31-35 36-40 41-45 46-50 50+

What is the name of the company for which you work? ________________________________________

What is your position in the company? ________________________________________________________

How did you hear about the contest: _________________________________________________

_______________________________________________________________________________

**If you are nominating someone else, you must provide us with their contact information in the space below:

Name: _______________________________________________

Address: _____________________________________________

City: ________________________ Postal Code: _____________

Email address: _________________________________________

Phone number: (home) ________________ (work) ___________

Tell us in 150 words or less why you (or the person you are nominating), deserves to become "London's Most Polished Professional".

_____________________________________________________________________________________________________

____________________________________________________________________________________________________

_____________________________________________________________________________________________________

______________________________________________________________________________________________________

_______________________________________________________________________________________________________

I hereby acknowledge that the information provided above is accurate and truthful.

Signature __________________________________ Date ________________________

There are several ways you can enter the contest:

1. You can email your entry form and photo to: This e-mail address is being protected from spam bots, you need JavaScript enabled to view it

2. You can drop off your entry form at Saffron Road (577 Richmond St., London, ON) or Kingsmills Department Store (130 Dundas St., London, ON - ladies wear department - 2nd floor) or David E. White (171 Queens Ave., London, ON)

3. You can mail your entry form to: Polished Image, 195 Pinebrook Place, London, ON, N5X 4C6

Click here for contest rules