Pure Rejuvenation Product Order Request Form

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Pure Rejuvenation Product Order Request Form

After you fill out this order request, we will contact you regarding if we are able fulfil the order and how long before the order can be completed before payment is taken.

Please request orders before 5pm on Sunday each week to be delivered the following Monday.

Free delivery is available when spending £45 or over within a 5 mile radius from Harold Wood, RM3 0WB.

If you would like faster service and direct information on current stock and pricing please contact us at Contact us at 07521973903 or info@purerejuvenation.co.uk.

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Email *

Are you a new or existing customer?

I am a new customer

I am an existing customer

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CLEANSERS

Please enter the product/s: Name, Size & Quality

TONERS

Please enter the product/s: Name, Size & Quality

MOISTURE LOTIONS

Please enter the product/s: Name, Size & Quality

MOISTURE CREAMS

Please enter the product/s: Name, Size & Quality

MASQUES

Please enter the product/s: Name, Size & Quality

TARGET PRODUCTS

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AGE RESIST

Please enter the product/s: Name, Size & Quality

TRAVEL SIZES

Please enter the product/s: Name, Size & Quality

ET MEN

Please enter the product/s: Name, Size & Quality

AROMATIC SERUMS / TREATMENT OILS

Please enter the product/s: Name, Size & Quality

SPA BODY SERUMS

Please enter the product/s: Name, Size & Quality

SPA BODY

Please enter the product/s: Name, Size & Quality

AROMATHERAPY FOOT CARE

Please enter the product/s: Name, Size & Quality

HAND WASH

Please enter the product/s: Name, Size & Quality

TEEN-SKIN ACTIVES

Please enter the product/s: Name, Size & Quality

AROMAWAX CANDLES

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3 Wick Candles;

Please enter the product/s: Name, Size & Quality

NATURAL REED DIFFUSERS

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DIFFUSER

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AROMATIC BLENDS

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SKIN CARE COLLECTIONS

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PERFECT PARTNERS

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SPA DUOS

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SPA SYNERGY DUOS

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SPA SYNERGY GELS

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Contact info

This information is used to process your order request.

Title

Mr

Mrs

Miss

Ms

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First name *

Surname *

Address *

Contact number *

PayPal E-mail address to compete order. *

Preferred contact method *

Phone

Email

Required

Pure Rejuvenation Marketing and communication

Would you like your email address to added to the Pure Rejuvenations newsletter for marketing purposes?

Yes

No

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What Service would you like to hear about?

Parents and baby classes

Wellbeing Treatments

Both

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GDPR Statement

GDPR Statement - Pure Rejuvenation will store the following information provided on this form: Names, address and contact details.

Consent You have opted to allow us to store your details for the purpose of communicating with you regarding purchasing products We will store this data for no longer than 12 months after your last purchase.

Marketing Consent

If you have opted to allow us to store your details for future marketing purposes, we will be storing this data under the legal basis of consent..

We will not share your data with any other organisation. If you wish us to remove or update your data, please contact us at: info@purerejuvenation.co.uk. You have the right to contact the Information Commissioner’s Office with any complaints or concerns.

Please read the GDPR statement below and tick the box to say that you are happy with the statement and how your information will be used. * *

I am happy with the GDPR statement and how my information will be used

A copy of your responses will be emailed to the address you provided.

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