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Competition

To have a chance of winning this awesome prize, please fill in the following (all fields are required to be completed to be included in the draw):






First Name:

Last Name:

Phone number:

Your Email:

Your Postcode:

Gender: MaleFemale

Date of Birth (If typed please enter as dd-mm-yyyy):

Which store did you make a purchase?

Receipt Number:

How did you hear about this competition?

I have read the Term and Conditions: YesNo

Do you want to hear more about any offers Good Sammy Stores may have in the future?: YesNo