&

PRESENT

POWERED BY

Nominee: Person Making Nomination (if different):

First Name: _____________________________
Last Name: _____________________________
Email Address: __________________________
Phone Number: __________________________
Address: _______________________________
City: ___________________________________
State: __________________________________
Zip Code: _______________________________
First Name: _____________________________
Last Name: _____________________________
Email Address: __________________________
Phone Number: __________________________
Address: _______________________________
City: ___________________________________
State: __________________________________
Zip Code: _______________________________

Please tell us why you, or someone you know deserves a Houseful of Furniture
from N.B. Liebman Furniture and $2,500 in cash from Renewal by Andersen.
(Please limit your response to 500 words or less; use back if needed)

Or email your submission to pamediagroup@pennlive.com

No purchase necessary. Open to PA residents 18 years or older within 30 miles of the PL/PN headquarters. Entry forms can be mailed or hand-delivered to
PA Media Group 2020 Technology Parkway, STE #300, Mechanicsburg, PA 17050. For a complete list of rules visit http://www.pennlive.com/deservingfamilygiveaway.