Your Information

Thank you for participating in the 2018 Readers' Choice Awards voting.

Please provide your information below in order to be entered to win one of five $20 gift cards.
(Voting will take place through Friday, August 3rd @ 5pm. Winners and Finalists will be notified by a member of the Rocky Mount Telegram advertising staff. The Readers' Choice 2018 magazine will publish on October 28th, 2018)

Name (First Last)

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* 1. Name (First Last)

Email Address

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* 2. Email Address

Phone (ex. (555) 555-5555)

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* 3. Phone (ex. (555) 555-5555)


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* 4. Address