Love Dunlop

LAST NAME:*

FIRST NAME:*

ADDRESS:*

POSTCODE:*

CITY:*

COUNTRY:

TELEPHONE:

MOBILE:*

Which Dunlop tyres did you purchase?

I have the following bike:

MODEL:

YEAR:

I ride miles per year

I use my motorcycle mainly for:

UPLOAD:*

Please upload a copy of your receipt (1MB filesize limit, only accepts JPG, PNG, GIF files)

EMAIL:*

Where did you hear about this promotion?

* Required

I hereby agree with the collection and use of my personal information for the above purposes. Goodyear Dunlop considers the individual information it maintains to be confidential, and we will not disclose your personal information to third parties without your consent, unless this is required by law or for the purposes of judicial or government investigations or proceedings. You are entitled to access, change or remove personal data held by Goodyear Dunlop.

I have read and I accept the Terms and Conditions of this Promotion.

DATE: