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Please provide some information about your enquiry

First Name:
Surname:
Email:
Phone (Landline):
Phone (Mobile):

	Tick below as appropriate:
	(a) I would like to join the £1 weekly Keech Hospice Care Lottery
	(b) I'd like information on Billy Howard's new Variety Showtime! show
	(c) Both (a) and (b) above
Message (optional):

	Thank you for your interest! One of our team will get back to you soon as possible. Team Supervisor.