Please complete ALL necessary fields accordingly. Registrations with unverifiable/incomplete entries will be ignored.

First Name:
Last Name:
Affiliation/Title:
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Mailing Address:
City:
ZIP Code:
Country:
Tel. Number:
FAX number:
E-mail address:

Please send me a proforma invoice.

Cheque/money order made payable to:
Turpin Distribution Services Ltd.
Pegasus Drive, Stratton Business Park
Biggleswade, Bedfordshire
SG18 8TQ, U.K.
Tel: +44 (0) 604800, Fax: +44 (0) 601640
URL: www.extenxa-turpin.com

I wish to pay by credit card.
Your credit card will be debited including VAT when applicable. (check below as appropriate)
(You will be contacted for credit card details)