Event materials order form
Materials order form Name Address
Postcode Daytime tel. no. Email
_____________________________________ _____________________________________ _____________________________________ _____________________________________ _____________________________________ _____________________________________ _____________________________________
Date materials needed for
__________________________
Please allow 2 weeks for processing and delivery from receipt of order. If you need your materials quicker than this please call 01628 529240 to order by telephone. We ask for a small donation for some items in order to keep the costs to the charity to a minimum.
Item code
Item
Size (please circle)
CLTTEEU
Alzheimer’s Society unisex cotton T-shirt
CLTCYC
Alzheimer’s Society unisex cycle top (breathable)
CLTRTEM
Alzheimer’s Society men’s running T-shirt
CLTRVSM
Alzheimer’s Society men’s running vest
CLTRTEL
Alzheimer’s Society women’s running Tshirt
CLTRVSL
Alzheimer’s Society women’s running vest
S M L XL XS 32-34” S 35-37” M 38-40” L 41-43” XL 44-46” XXL 47-49” S 38” M 40” L 42” XL 44” S 38” M 40” L 42” XL 44” size 10 size 12 size 14 size 16 size 18 size 10 size 12 size 14 size 16
Qty
Suggested Total donation £5.00 each
£15.00 each
£10.00 each
£10.00 each
£10.00 each
£10.00 each
ASCAP ASSWEAT
Alzheimer’s Society swimming cap Alzheimer’s Society wrist sweatband TOTAL DONATION
size 18 One size
£5.00 each
One size
£3.00 each
£
For more branded merchandise visit shop.alzheimers.org.uk
HOW TO PAY: Please complete the following or call 01628 529240 to pay by debit/credit card. We cannot accept American Express, Diners, Solo or RBS Highline cards - apologies. I authorise Alzheimer’s Society to debit my Maestro/Visa/Mastercard for the total donation amount of £ __________ Name as it appears on the card_____________________________________________ Card No_______________________________________________ Issue No_______ Valid from / Issue Date ___ /____ Expiry Date _____/_____ (We will call you for your card’s security number in order to process your payment) Signed______________________________________________ Date ___ / ___ / ___ Card holders name and address above if different from delivery address:
______________________________________________________________________ Alzheimer’s Society will process and safeguard your details in accordance with the Data Protection Act 1998. We will not share information with third parties for marketing purposes and will only pass on details as part of our business with you.
POST YOUR FORM TO: Alzheimer’s Society c/o Riverside, 85 - 87 Holtspur Lane, Wooburn Green, Bucks, HP10 0AU
Postcode Daytime tel. no. Email
_____________________________________ _____________________________________ _____________________________________ _____________________________________ _____________________________________ _____________________________________ _____________________________________
Date materials needed for
__________________________
Please allow 2 weeks for processing and delivery from receipt of order. If you need your materials quicker than this please call 01628 529240 to order by telephone. We ask for a small donation for some items in order to keep the costs to the charity to a minimum.
Item code
Item
Size (please circle)
CLTTEEU
Alzheimer’s Society unisex cotton T-shirt
CLTCYC
Alzheimer’s Society unisex cycle top (breathable)
CLTRTEM
Alzheimer’s Society men’s running T-shirt
CLTRVSM
Alzheimer’s Society men’s running vest
CLTRTEL
Alzheimer’s Society women’s running Tshirt
CLTRVSL
Alzheimer’s Society women’s running vest
S M L XL XS 32-34” S 35-37” M 38-40” L 41-43” XL 44-46” XXL 47-49” S 38” M 40” L 42” XL 44” S 38” M 40” L 42” XL 44” size 10 size 12 size 14 size 16 size 18 size 10 size 12 size 14 size 16
Qty
Suggested Total donation £5.00 each
£15.00 each
£10.00 each
£10.00 each
£10.00 each
£10.00 each
ASCAP ASSWEAT
Alzheimer’s Society swimming cap Alzheimer’s Society wrist sweatband TOTAL DONATION
size 18 One size
£5.00 each
One size
£3.00 each
£
For more branded merchandise visit shop.alzheimers.org.uk
HOW TO PAY: Please complete the following or call 01628 529240 to pay by debit/credit card. We cannot accept American Express, Diners, Solo or RBS Highline cards - apologies. I authorise Alzheimer’s Society to debit my Maestro/Visa/Mastercard for the total donation amount of £ __________ Name as it appears on the card_____________________________________________ Card No_______________________________________________ Issue No_______ Valid from / Issue Date ___ /____ Expiry Date _____/_____ (We will call you for your card’s security number in order to process your payment) Signed______________________________________________ Date ___ / ___ / ___ Card holders name and address above if different from delivery address:
______________________________________________________________________ Alzheimer’s Society will process and safeguard your details in accordance with the Data Protection Act 1998. We will not share information with third parties for marketing purposes and will only pass on details as part of our business with you.
POST YOUR FORM TO: Alzheimer’s Society c/o Riverside, 85 - 87 Holtspur Lane, Wooburn Green, Bucks, HP10 0AU
