2011 Ugliest Kitchen Contest Registration Form

YBC is in search of Central PA's Ugliest Kitchen!

Wish you could replace your old, tacky, ugly, mismatched Kitchen? This is your chance! Let YBC help you turn your old, ugly kitchen into a brand new one! To apply, fill out the form below and submit at least (3) photos highlighting the reasons you think you have the "Ugliest Kitchen".

Full Name

Last NameFirst Name

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Home Phone #

Area CodePhone Number

Cell Phone #

Area CodePhone Number

Work Phone #

Area CodePhone Number

Fax #

Area CodePhone Number

E-mail

Is it ok if we email you news, updates and promos in the future?

Do you own your own home?

How did you find out about this contest?

Which YBC location do you shop at?

Why is your kitchen the ugliest? (150 word or less essay)

Upload Picture 1 (max size 1 MB)

Upload a File

Upload Picture 2 (max size 1 MB)

Upload a File

Upload Picture 3 (max size 1 MB)

Upload a File

PLEASE READ THE FOLLOWING STATEMENT: I hereby acknowledge that (1) I have fully read and understand the official rules for YBC’s "Ugliest Kitchen Contest" sponsored by YBC and agree to be bound by all eligibility requirements; (2) I have answered the previous questions honestly and accurately; (3) If any of the above information is found to be false or misleading, this will be grounds for dismissal from YBC’s "Ugliest Kitchen Contest" contestant selection process and/or winning the Grand Prize, if selected; (4) I give YBC the right to use the pictures and contest form for their discretionary future use without any royalties expected in return (5) all decisions by the judges concerning selection of the participants are final and are not subject to challenge or appeal.

Agree? You must agree to continue.

OFFICIAL ENTRY FORM