To enter to win a two year lease of a 2013 C-MAX Energi, please tell us a little about yourself in the spaces below and click on 'Submit.'
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First Name*
Last Name*
Email Address*
Confirm Email Address*
Mailing Address*
Apt Suite #
State* Zip*
Phone Number
When do you plan to purchase your next vehicle?*

How do you plan to acquire your next vehicle?*

Please send me information on the following Ford vehicle(s): (Choose up to 3)

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