Face Shield Order Form

Face Shield Order Form
Name *

Title First Name Last Name
Email *
example@example.com
Contact Phone Number *

Area Code Phone Number
Delivery Address *

Street Address

Street Address Line 2

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Price

A minimum of 2 Shields

Price - £5.90 + P&P

Postage & Packaging - £1.50
How many shields do you require? *
Methods of Payment
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Face Shield £ 2.95 GBP

Quantity

Subtotal £ 0.00 GBP Shipping £ 0.00 GBP Total £ 0.00 GBP
BACS: complete details below
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If you have a purchase order number, please fill in the box below
Company Name
(If applicable)
Invoice Address if different from above

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Marketing Communications
Lymphoedema Training Academy, or partners would like to keep you informed of other products or services relating only to your enquiry, If you do not wish to receive info please let us know. (Please note that LTA will however contact you with regards to your order)

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For further information about how we collect and use your data, please see our Privacy Notice

http://www.lymph.org.uk/privacy-notice/
Thank you for your order!

Please note: Your order will be dispatched once payment has been received.
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