Buy Local and Win

Name:*
Contact Phone Number:*
E-mail:
Postal Address:

Enter the following details.  You MUST keep your purchase receipt and present it to claim your prize.

Date of Purchase:*
Business Purchased From:*
Amount of Purchase (must be $50 or more to enter):*
How did you hear about this promotion?*

Terms and Conditions:
1. To enter the draw for $250 a shopper must spend $50 in a single transaction at a business located in the Quilpie Shire Council area.
2. Individual entries are valid for one month only.
3. Entries for the respective draws close at 12.00 noon on Thursday 29 June.
4. The original purchase receipt must be presented to claim a prize. If the receipt is not able to be presented a re-draw will occur.