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After your have filled in your information, please cilck the Submit Botton in the bottom of this page. Thank you for your interest in our service.
Details of Subscriber  
Name of subscriber : *
Name of company : *
Address :
(for our delivery service)		 *
Methods of Payment : *
Address :
(for our cash/cheque collection)		 *
Your Email address :
Tel No. : *
Fax No. :
Inital bottle deposit :   bottles.*
Name of the person with whom we can contact when we are arranging the regular service to your location. *
  What is the capital of England and the United Kingdom?
 
  * Required field