Event contact form

Name

Prefix First Last

Job title

Organisation name

Address

Street Address Address Line 2 City County Postcode

Telephone number

Email address

If you already hear from us, we will continue to contact you in the same way. If you don’t already hear from us, we’d like to send you information in the post and/or over the telephone about events, research, fundraising, appeals and our regular newsletters & updates.

If you would prefer not to receive information in the post please tick here

If you would prefer not to receive information over the telephone please tick here

It’s often cheaper for us to contact you via email or SMS (text message) – please tick the boxes below if you’re happy for us to contact you in this way:

Text

Your privacy is our priority. We promise to keep your details safe and will never sell them. Just for your information we use an email broadcast company based in the USA. Would you like to know more? our privacy policy explains all: RetinaUK.org.uk/privacy-policy.

If you would like to change the way you hear from us, how we use your information or do not want to receive and further communications from us, just email info@RetinaUK.org.uk, call 01280 821334 or write to us at Retina UK, Whiteleaf Business Centre, 11 Little Balmer, Buckingham MK18 1TF.

Notes (for internal use only)