21A Newington Avenue, Cudworth, Barnsley, South Yorkshire, S72 8TP. Tel: 01226717452

Please print and complete this form and send it to John Clarke at the address shown above.

Please circle the subscription of your choice.

TOWERFORM UK RATINGS

One Month £15-00

Three Months £37.50

Six Months £75.00

One Year £150-00

TOWERFORM UK & IRISH RATINGS

One Month £20-00

Three Months £50.00

Six Months £100.00

One Year £200-00

TOWERFORM UK RATINGS PLUS SELECT

One Month £20-00

Three Months £50.00

Six Months £100.00

One Year £200-00

TOWERFORM UK & IRISH RATINGS PLUS SELECT

One Month £25-00

Three Months £62.50

Six Months £125.00

One Year £250-00

TOWERFORM UK & IRISH RATINGS PLUS DUTCH ULTRA (WHICH INCLUDES SELECT)

One Month £40-00

Three Months £100.00

Six Months £200

One Year £400-00

I would like to subscribe to the above service for the period indicated.

I enclose a Cheque / Postal Order (made out to John Clarke) for the indicated amount of

£………….

Name…………………………………………………………..

Address (optional)…………………………………………….

…………………………………………….

…………………………………………….

.……………………………………………

…………………………………………….

Email address………………………………………………….

Date…………………………………………