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CHANGE SOMEONE'S LIFE DELL CONTEST ENTRY FORM

Change YOUR Life SCHOLARSHIP Contest Entry Change SOMEONE'S Life DELL Contest Entry Rules & Regulations

Change YOUR Life SCHOLARSHIP Contest | Change SOMEONE'S Life DELL Contest | Brain Dominance Test | View Schools / Programs / Scholarships

The Change SOMEONE'S Life DELL Contest rules are simple. For each person you invite to win a full scholarship, or invite
to take the brain dominance test, we will enter you to win the Change SOMEONE'S Life DELL Contest.

If you decide to do both we will enter you twice. You are invited to enter as many times as you like and invite as many
people as you wish.

[An asterisk (*) indicates a required field]

Section A: Please select the school scholarship you wish to invite the person/s to win - or invite them to take the brain dominance test, or both.

If you yourself are interested in more information on a particular program at this school, please select a location and program below and check the box.

*

Check box if you would also like more info on this particular program in the form of a program info kit

Section B: Enter yourself to win a DELL E6510 15.6-inch laptop and DELL laser printer by making your selection below. *

I wish to nominate the following person(s) in Section D to win a full scholarship
I wish to invite the following person(s) in Section D to take the Brain Dominance Test
I wish to do both of the above and double my chances of winning for each person I enter in Section D

Section C: Please tell us about yourself below
Your information

Email Address: *
First name: *
Last name: *
Day phone: *	- -
Address: *
Address 2:
City: *
Province/State: *
Zip/Postal Code: *
Country: *

Section D: The person/s I wish to nominate to win the full scholarship, invite to take the brain dominance test or do both are:

First name:
Last name:
Email Address:

First name:
Last name:
Email Address:

First name:
Last name:
Email Address:

High School Grad Year *
I plan on furthering my education in the following time-frame: *