DVD order form

Please print off and follow instructions.

                                 ROCK FOR HAVENS SAKE DVD ORDER FORM

I would like to purchase  ________________ Copies of the DVD of the RFHS 2011 Music Festival at a cost of £10.00 per DVD. (Havens Hospices will receive £6.00 from the sale of each DVD, £1.00 covers postage and packing and £3.00 covers the production costs)

Total payable:  £ ________________    

Cheques to be made payable to:   ROCK FOR HAVENS SAKE MUSIC FESTIVAL 

Please send all remittances to: DVD Order, Rock for Havens Sake Music Festival, 2 Southwick Road, Canvey Island, Essex SS8 0EP

 Please note DVD's will not be dispatched until cheques have cleared.

Name:_________________________________________________________________________________________

Address: _______________________________________________________________________________________

Post Code:   ____________________   

Contact No: ___________________________

Email: ______________________________________________________________

Please write your details clearly. Any information you give is strictly confidential.

Delete as applicable.

I would like to be kept on the mailing list for Rock for Havens Sake    YES / NO

I would like to volunteer as a helper with Havens Hospices                   YES / NO

I would like to volunteer as a helper with RFHS Music Festival             YES / NO

I am a band member                                                                                   YES /NO 

Name of Band ______________________________________________________________________________