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The Great Chingford Takeaway Survey

In association with:

Next time you order a takeaway simply complete the survey below and you will be entered into our draw to win £50 to spend at the Wine Factor in Station Road
Wine Factor currently has offers on great beers and wines which go perfect with a takeaway.
More details here: Wine Factor

Terms and conditions apply, entries valid up until 31st December 2012

* Indicates required


Your favourite Takeaway (*)
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How often do you use them?
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General quality of food
(1-Poor 5-Excellent)
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Any other comments?
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To be entered into our prize draw you will need to provide your contact details so we can inform you if you have won. Details will be kept confidential and not passed on to any third parties unless you agree to

Your Name (*)
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Your email address (*)
Please enter a valid email address so we can contact you if you win!
Tel (*)
Please enter a telephone number we can contact you on in case you win!
I would like to hear about local offers from Chingford based businesses:
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I would like to receive offers from businesses from other areas as well:
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