Order Accord merchandise for your event | Rep forms

A. Details

First name*

This field is required

Surname*

This field is required

Employee Number / ID*

This field is required

Email address

Email address*

Please enter a valid email address

This field is required

This type of email address is internal to LBG and cannot be used externally. Please provide an external email address.

B. Workplace

Employer

This field is required

Workplace address*

This field is required

Start typing your address Enter address manually

Contact address Change address

Address line 1*

This field is required

Address line 2

Town*

This field is required

County

Postcode*

This field is required

C. Merchandise order details

Please select the number of merchandise items you require. The maximum order per item is 100 (per large site) and 25 (per branch).

D. Literature order details

Please select number of literature items you require.

Reason for request*

This field is required

Where would you like the items sent to?

Start typing your address Enter address manually

Contact address Change address

Address line 1*

This field is required

Address line 2

Town*

This field is required

County

Postcode*

This field is required

Special delivery instructions

What date would you like them?*

Please allow at least 7 working days’ notice

DD MM YYYY

Please enter a valid date

Recruitment merchandise order form