Please print this form and send it with a cheque for £10 to:
Peter Delves Associates, 39 Randall Road, Kenilworth, Warwickshire, UK CV8 1JX.
Cheques to be made payable to "Peter Delves".

NAME

ADDRESS & POSTCODE

TELEPHONE (Optional)               

E-MAIL ADDRESS (Optional)                                                   

I ENCLOSE:

A cheque for £10 made payable to “Peter Delves”

Signed……………..…………………………………Date…………………………