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$1,000 Gift Card Entry Form
You must be a legal resident of Canada who has reached the age of majority in their respective province at the time of participation.
Please read the official
Rules & Regulations
for complete details.
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Contact information
First name
*
Last Name
*
Address
*
Apt. #
Province
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Alberta
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Age
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Gender
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Daytime Phone Number
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(10 digits – no dashes or spaces)
E-mail Address
*
(yourname@company.com)
Where do you normally purchase your shoes?
*
Select
Chaussures POP
Club Chaussures
Jean Paul Fortin
Les Pieds Sur Terre
Luigi Chaussures
Naturalizer
Nero Bianco
Perfecto
Shoe Company
Sterling
Town Shoes
Yellow
Other
How did you hear about us?
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Email
In Store
Tana.ca Website
Website advertisement
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Other
Product information
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