Radar Key Order Form - Urostomy Association

Available to members only.

Fields marked with * are required.

Name*

Title First Last

Address*

Address 1 Address 2 City Postcode

Telephone*

Email*

Enter Email Confirm Email

Dated*

Select your branch*

Membership number (if known)

Declaration*

Please tick the box below
I AM chronically sick or disabled (defined as substantially and permanently handicapped by illness, injury, or congenital deformity) and am buying an NKS (RADAR) key from the Urostomy Association for my personal use, and I claim that the supply of it is eligible for relief from VAT under group 14 of schedule 5 of the Value Added Tax 1983. Having a urostomy does class as a disability.

Total

£ 0.00

Payment Method*

Credit/Debit Card
PayPal

Credit/Debit Card Details*

Card Details

Cardholder Name

Here at the Urostomy Association we take your privacy seriously and will only use your personal information to support you and to provide the products and services you have requested from us. Your personal details will NOT be passed to any third-party.

Data Consent*

I have read the Terms & Conditions and agree to the processing of my data as outlined in the Privacy & Cookie Policy

Name

This field is for validation purposes and should be left unchanged.