Please Note: A valid completed survey and followup call is required to be eligible for the courtesy gift card.
Your Information
First Name:	*
Last Name:	*
City:	*
State:	AL AK AZ AR CA CO CT DE FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA PR RI SC SD TN TX UT VT VA WA DC WV WI WY   Zip:	*
Home Phone:	*
[1] Wireless Service
Current Provider:	*
Satisfaction:	I love my current provider I am open to using a different provider
Monthly Bill$:	*
Monthly Minutes:	*
Months Left:	*
Last Upgrade:	*
No. of Phones:	*
Data Plan:	Yes, I currently have a data plan with my phone No, I currently DO NOT have a data plan with my phone
Wireless Card:	Yes, I'm interested in a wireless card for my laptop No thanks
[2] Local/Long Distance Service
Current Provider:	*
Primary Phone#:	*
Monthly Bill$:	*
Bundled with:	Internet TV Both Not bundled
International Calling:	Yes, I currently have an international calling plan No, I currently DO NOT have an international calling plan
Long Distance Plan:	Yes, I currently have a long distance plan No, I currently DO NOT have a long distance plan
Unlimited Calling:	Yes, I am interested in Unlimited Calling No, I am NOT interested in Unlimited Calling
[3] High Speed Internet Service
Current Provider:	*
Monthly Bill$:	*
Type of Service:	Cable DSL Dial-up Wireless Aircard None
Bundled with:	Phone TV Both Not bundled

[4] TV Service
Current Provider:	*
Monthly Bill$:	*
Bundled with:	Internet Phone Both Not bundled
No. of Receivers:	*
Months Left:	*
Receiver Types:	I currently have HDTV I currently have DVRs Both None of the Above
[5] Home Security Service
Current Provider:	*
Monthly Bill$:	*
Service:	I do not use a home security service I have a home security service but am interesed in more info I'm good
[6] Digital Service w/Video Phone
Interested:	I am interested in Digital Phone Service (Unlimited Calling) I would like to see with whom I am speaking Both I'm good
[7] Computer Support
Current Provider:	*
Biggest Repair Bill$:
Backups:	I am not currently backing up my precious files I am backing up my precious files, and the backup is sitting right next to my computer I am backing up my precious files, and they are in a safe location What's a backup?
Ever Been Infected:	No, I practice safe computing Ummm...
Services Used:	Friend or Family Member National Provider Remote Service All by myself
Additional Information:
Terms and Conditions:
Conditions of Participation/Release: By participating, entrants agree to be bound by these official rules and the decisions of Mavtechs, which shall be final in all respects. Offer is void where prohibited or restricted by law. All federal, state and local laws and regulations apply. All posts, comments, edits and other materials added to Mavtechs's website as a result of this contest become the sole property of Mavtechs and entrants authorize Mavtechs to use said content in whatever manner it wishes. By participating in this Offer and/or by accepting any prize that they may offered, entrants agree to release Mavtechs, their parent, subsidiary and affiliated companies, units and divisions and advertising and promotional agencies and prize suppliers; each of their respective officers, directors, agents, representatives and employees; and each of these companies and individuals' respective successors, representatives and assigns (collectively, the "Released Parties") from any and all actions, claims, injury, loss or damage arising in any manner, directly or indirectly, from participation in this Offer and/or acceptance or use of the prize. The Released Parties shall not be liable for: (i) late, lost, delayed, stolen, misdirected, postage-due, incomplete, unreadable, inaccurate, garbled or unintelligible entries, communications or affidavits, regardless of the method of transmission; (ii) telephone system, telephone or computer hardware, software or other technical or computer malfunctions, lost connections, disconnections, delays or transmission errors; (iii) data corruption, theft, destruction, unauthorized access to or alteration of entry or other materials; (iv) any injuries, losses or damages of any kind caused by the prize or resulting from acceptance, possession or use of a prize, or from participation in the Offer; or (v) any printing, typographical, administrative or technological errors in any materials associated with the Offer. Mavtechs disclaim any liability for damage to any computer system resulting from participating in, or accessing or downloading information in connection with this Offer, and reserve the right, in their sole discretion, to cancel, modify or suspend the Offer should a virus, bug, computer problem, unauthorized intervention or other causes beyond Mavtechs's control, corrupt the administration, security or proper participation of the Offer. Mavtechs may prohibit you from participating in the Offer or winning a prize if, in their sole discretion, they determine you are attempting to undermine the legitimate operation of the Offer by cheating, hacking, deception, or any other unfair participation with the intent to annoy, abuse, threaten or harass any other entrants or Mavtechs representatives. This Offer will be governed by the internal laws of the State of Colorado. Any and all legal actions or claims arising in connection with this Offer must be brought in a court of competent jurisdiction within Colorado and you hereby submit to jurisdiction in Offer. CAUTION: ANY ATTEMPT TO DELIBERATELY DAMAGE THE WEB SITE OR UNDERMINE THE LEGITIMATE OPERATION OF THE OFFER MAY BE IN VIOLATION OF CRIMINAL AND CIVIL LAWS AND WILL RESULT IN DISQUALIFICATION FROM PARTICIPATION IN THE OFFER. SHOULD SUCH AN ATTEMPT BE MADE, Mavtechs RESERVES THE RIGHT TO SEEK REMEDIES AND DAMAGES (INCLUDING ATTORNEY FEES) TO THE FULLEST EXTENT OF THE LAW, INCLUDING CRIMINAL PROSECUTION.
I Agree to the Terms:*
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