Shop Small to Win Contest Entry-2021

4. 
6. Shop Small to Win

   Shop (online or in-person) from a Mount Airy independently-owned business!

   Shop November 1st through December 5, 2021 and spend at least $25.

   Submit your receipt by December 7th at 4:30 PM for your chance to win the Grand Prize worth $5,000!

   Grand Prize includes $4,500 in cash plus $500 in gift cards to Mount Airy businesses.

   You may enter as many times as you wish!

8. Receipt Image Upload*
   One receipt is one submission and may not be duplicated. If you have two receipts from the same store that total at least $25, please email [email protected] with an image of the second receipt.
9. Dollar Amount Spent*
   Receipt must total at least $25.
11. Store Name
    -- Select One --A Do or Dye Day SpaAnimal Health Center - Dr. O'BrienAnita's LiquorsBen Gue Antiques & GiftsBlossom and Basket BoutiqueBolderBrowning Reagle InsuranceCarroll LiquorsCarterQue BBQ & Grilling Co.Castle LiquorsChewey's Performance Auto, IncChiropractic First Family Wellness CenterChong Yet Yin Chinese RestaurantConcetta's Mainstreet BistroCore YogaCozy Pools & SpaCryin' JohnniesD&D; Cleaners of Mt. AiryDeJa Vu BoutiqueDR SnellFour County Import ServiceGaver Farm, LLCGeorge's Girls JewelryGun ShackHair ImpressionsHappy Dog Grooming SalonHealth UnlimitedJimmie Cone of Mount AiryJWS SalonKatana SushiLa Bella MedispaLaurienzo Brick Oven CafeLeslie Home GalleryLinganore WinecellarsLofted on MainLuxury Nails and SpaMagone Dental PCMamma Angela'sMed One PharmacyMemories Charcoal HouseMilkhouse BreweryMISCellaneous DistilleryMommy Magic CakesMount Airy Animal HospitalMount Airy CommonsMount Airy Dental Center, LLCMount Airy Eye CareMount Airy InnMount Airy LiquorsMount Airy MattressMount Airy NailsMount Airy Veterinary AssociatesMt Airy Ace HardwareMt. Airy Bicycle CompanyMt. Airy LanesNew York J & P PizzaOlde Town RestaurantParadise NailsPatapsco Bike and SportPatches Quilting and SewingPosh Nails and SpaProspect Small Engine LLCReflections Hair DesignRehab 2 PerformRidgeville Service CenterShear DimensionsSiempre de FiestaSK PrintingSt. James Thrift ShopStablemates IncStudio AllureSuperfoods Cafe & MarketSURAH Japanese SteakhouseThe Fern FarmerThe Grille at ChalledonThe Last WordThe PlumberyThe Toy ExchangeThe Upper Deck Sports BarTim's Lawn & Landscape Service, IncTip Top NailsTrain DepotTristar Martial ArtsTropic Nail & TanningTwin Arch Self StorageTwin Arch TavernWagner's Meats, LLCWedlocks, LLCWellness PointYork AutomotiveYoung's Nursery and GreenhousesOther

    Please email [email protected] to have a businesses added.

12. If other, please specify store name
14. Store Zip Code*
15. Date of Purchase*
    Date of Purchase

    Only purchases made 11/1/2021 - 12/5/2021 are eligible

17. If it weren't for this contest, would you have made this purchase at a Mount Airy store?*

    1. YES
    2. NO
    3. MAYBE
19. Additional comments:
21. Please include as much contact information as possible. If we are unable to contact the chosen winner, another winner will be selected on December 13, 2021.
23. First Name*
24. Last Name*
26. Email Address*
27. Phone Number*
29. Alternate Email Address
30. Alternate Phone Number
32. Home Address
34. City
35. State
36. Zip Code*
38.  

    1.  Please; add my email to the Town of Mount Airy Newsletter list.
40. 1. DO NOT enter me into the contest, but count my receipt towards the total sales for $hop $mall.
42. Entries must be received by Tuesday, December 7, 2021 at 4:30 PM.

    Receipts may also be dropped at Mount Airy Town Hall's drop box by December 7, 2021 at 4:30 PM. The address is:

    
    Town of Mount Airy

    110 S. Main St

    Mt. Airy, MD 21771

44. Winner will be contacted using the contact information provided starting December 10, 2021 immediately following drawing.
    
    Check presentation will be the week of December 12, 2021.
46. A printable entry form can be found at Information for Businesses Page. Printed forms will be available outside Town Hall.
Leave This Blank:


48. 1. Receive an email copy of this form.
49. Email address

    This field is not part of the form submission.

50. Submit

* indicates a required field