Cementex Smokin' Giveaway

Name (As it appears in your invitation)

First

Last

Company

your Name electrical

Address

Address Line 1

Address Line 2

City

State

Zip Code

Primary Phone Number

Phone Type

Cell
Office

SMS / Text Messaging

Yes

By checking this box, you consent to receive SMS/text messages from Cementex Products, Inc. at the mobile number provided. Message and data rates may apply. Message frequency varies. You can reply STOP at any time to opt out, or HELP for help. Consent is not a condition of purchase.

Primary Industry

Other:

Are you a Professional Electrician

Are you "Qualified" for any level of live electrical work?

Password

Enter the secret password provided on the video from our YouTube channel.

Checkboxes

Winner accepts all tax implications.

All prizes may be subject to federal, state, and local taxes. The winner is solely responsible for reporting and paying any such taxes. Cementex Products, Inc. may issue an IRS Form 1099-MISC if required by law.

Cementex Smokin’ Giveaway

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