'TOGETHER' PROMOTION PACKAGE  - BOOKING FORM

 Post to:
Memory Boxes, PO Box 9164, Marchent, Nottingham, NG4 9BJ

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1. I would like to register for

'Together' Promotion Package

@ £28.00 per business listing

£____________

Total:

£____________

2. Please list my business under the following two categories (please circle your selection) 

3. My Business details

Business Name:

_____________________________________

Business Address:

_____________________________________

Telephone Number:

_____________________________________

Business Description:

_____________________________________
_____________________________________

[upto 30 words]

Email address:

_____________________________________

Business Website:

http:// ________________________________

4. My Payment details

To pay by cheque:

I enclose my cheque / postal order for £____________ (payable to Memory Boxes)

To pay by credit or debit card:

Signature: ____________________    Please Print Name: _____________________

Please ensure the cardholder's address is shown on the order form

Customer Order Reference (if applicable):  _________________