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Name:   
Company Name:   
Trading Name:   
Trading Address:   
Telephone:   
Fax:   
Email:   
Website:   
Registered Office   
Number of Vans:   
Number of Motorcycles:   
Number of Bicycles:   
Number of Cars:   
Associated Companies:  

 Signed:



Cheques to be made payable to "The Despatch Association"

If paying other than by cheque please specify

Please include a cheque for £58.75 and return to:
The Despatch Association,
Lamb’s End House,
36 Church Rd.,
Magdalen, King’s Lynn,
Norfolk PE34 3DG

Tel/Fax:    01553 813479