Acossi Giveaway iPod Sign up form (available 2GB mini iPod)

Type your name, e-mail address, and zip code in the boxes below:
(*required fields)    
First Name*    
Last Name*    
E-mail Address*    
Address*    
Address 2     
Country
State
Zip Code/ province*    
Receipt Order# *    
Online Store name *  
Check the boxes below if you would also like to receive e-mail
updates regarding:
   Other giveaways.
   New Release & events.
  
Rules:
  • The winner will be chosen randomly by acossi.com staff.
  • Winner will be Contacted & Announce.
  • Open to entrants from anywhere in the world. Must be 13 & older
  • All responsibility in the delivery of the prize lies with Acossi.
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