EmailMe Form - KCEDC 2023 '920' Pledge Registration Form

KCEDC 2023 '920' Pledge Registration Form

Spend a minimum of $20 in each of 9 different Kewaunee County stores during the 2023 holiday season.

Submit this completed pledge form along with copies of your receipts by 5pm on December 31, 2023 to be entered into a drawing for gift certificates from the Algoma Area Chamber of Commerce, Kewaunee Area Chamber of Commerce, and Luxemburg Area Chamber of Commerce totaling $180!

Winner will be drawn on January 8, 2024.

Receipts must be dated November 1 - December 31, 2023, and show the store name, date, and sale amount to qualify.

Name *
First Last
Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region
Phone *
### - ### - ####
Email
Please list the 9 Kewaunee County businesses where you spent at least $20 during the 2023 holiday season.
Store #1 *
Store #2 *
Store #3 *
Store #4 *
Store #5 *
Store #6 *
Store #7 *
Store #8 *
Store #9 *
Please upload a copy store #1 receipt here. *
File types accepted: PDF, Word, .jpg, .png, or .gif.
Please upload a copy store #2 receipt here. *
File types accepted: PDF, Word, .jpg, .png, or .gif.
Please upload a copy store #3 receipt here. *
File types accepted: PDF, Word, .jpg, .png, or .gif.
Please upload a copy store #4 receipt here. *
File types accepted: PDF, Word, .jpg, .png, or .gif.
Please upload a copy store #5 receipt here. *
File types accepted: PDF, Word, .jpg, .png, or .gif.
Please upload a copy store #6 receipt here. *
File types accepted: PDF, Word, .jpg, .png, or .gif.
Please upload a copy store #7 receipt here. *
File types accepted: PDF, Word, .jpg, .png, or .gif.
Please upload a copy store #8 receipt here. *
File types accepted: PDF, Word, .jpg, .png, or .gif.
Please upload a copy store #9 receipt here. *
File types accepted: PDF, Word, .jpg, .png, or .gif.
By checking this box you certify that you have visited a minimum of 9 Kewaunee County businesses and have spent a minimum of $20 at each of them this winter holiday shopping season by listing them in the above section.

You understand that your winnings will be made up of 3 equal amount gift certificates from the Algoma Area Chamber of Commerce, Kewaunee Area Chamber of Commerce, and Luxemburg Area Chamber of Commerce totaling $180.
Check this box to certify your pledge

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Please list the 9 Kewaunee County businesses where you spent at least $20 during the 2023 holiday season.