Please enter your information below in order to be eligible for a $100 gift card from Amazon.
Entry form best viewed in the Chrome or Firefox browsers.
Phone number is only used to contact the winner. Only one submission allowed per contestant. Duplicates will be disqualified.
Contest Details
Thank you for taking time to participate in this important survey. Your feedback is critical to the future work of your CMDA. In appreciation of your participation, we invite you to enter your name for a drawing to win a $100 gift card from CMDA. Prize is not transferable, and cannot be exchanged for cash. This prize is voided where prohibited by law.