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Registration
 
Sign up using your Facebook account to post your activity to Facebook.
 
Or
 
 
Register for our contest by filling out the form below. Registration is required for nomation submissions and voting.
 
General Information
 
* First Name: 
 
* Last Name: 
 
* Public Name: 
 
  Must be 4-10 characters
 
* Birthday: 
   
 
* Email: 
 
  Only one registration is allowed per email address.
 
* Confirm Email: 
 
* Phone: 
 
* Address Line 1: 
 
Address Line 2: 
 
* City: 
 
* State: 
 
* Postal Code: 
 
  
    I agree to receive marketing information from La-Z-Boy Furniture Galleries of Madison.
 
  
    I'd like to sign up for Best Deals Madison & Beyond emails.
 
 
 
Password Information
 
Passwords must be 8 to 20 characters.
 
* Password: 
 
* Confirm Password: 
 
Double check to make sure your information is correct and then hit SUBMIT below.
 
 
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$500 Apple For Your Teacher 2014

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