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LYMPHOEDEMA ALERT BRACELETS ORDER FORM

Please print out this page and complete as appropriate.
    Single (£1 each).......... Please state
        Multiples (6 for £5).......... number required

(Prices are inclusive of postage and packing).     Amount: £_______
 
Please enclose your cheque (in £ Sterling only)Donation:      £_______
made payable to:
The Lymphoedema Support NetworkTOTAL: £_______

Delivery address (please print clearly):

Name:

Address:



Post Code:

Tel. No.:

Please allow 21 days for delivery.

We regret that at present we are unable to process overseas orders.

Please return to:
The Lymphoedema Support Network
St. Luke's Crypt
Sydney Street
London SW3 6NH
Registered Charity No. 1018749
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