2014 Home Service Plus VIP Sweepstakes

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* 1. Contact Information:

Name: *

Address:

Address 2:

City/Town:

State:

ZIP: *

Email Address: *

Phone Number: *

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* 2. Are you a current HSP Customer?

Yes

No

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* 3. What age is your home comfort equipment?

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* 4. What products & services are you interested in?

Replacement Assistance Plan

Hearth Products

Dryer vent cleaning

Pipe protection

Water heater

Indoor air quality products

A/C

Furnace

Maintenance plan

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* 5. Home Service Plus may contact me periodically with promotions, special offers, and/ or updates

Yes

No

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* 6. The Minnesota Swarm may contact me periodically with promotions, special offers,and/ or updates.

Yes

No