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This form to be used for the acquisition of an Reminder Wrist band to 'Please place your handhelds here'.
Email address
The wristbands come in many colours, randomly sent.
Please write your/the name in the box below to whom I should send the wristband.
Your answer
Please put your address in the box below, and I will send the wristband straight away.
Your answer
A copy of your responses will be emailed to the address you provided.
Please complete the captcha before submitting the form.
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