Filterqueen Sweepstakes

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Welcome to the 2008 FilterQueen® $25,000 Spend It Your Way Cash Sweepstakes, sponsored by HMI Industries Inc. and participating authorized FilterQueen® distributors. Please fill out the form below and click send to be entered into the drawing.

* Indicates this field is required for form to process correctly.
First Name*	Last Name*
Street Address*	Address 2
City*	State*
ZIP Code*
Home Phone* (No Separators Please)
E-mail Address*
*Marital Status Single Married	Spouse's Name
*Housing Own Rent	Approximate Household Income
*Age Under 21 21-24 25-39 40-49 50-75 76+
Does anyone in your home suffer from allergies or asthma? Yes No
Do you own any pets? Yes No
*How did you hear about us? Magazine Ad Internet Flyer Trade Show Other
Yes, I would like to hear about future promotional offers from FilterQueen®.
*Signature By providing my name and phone number, I am providing my electronic signature and consent to be contacted by the sponsors of this promotion, even if my number is found on a statewide or national do not call registry or list. Please read the 2008 Sweepstakes Official Rules.