Gorenje cash back offer form

THIS OFFER IS ONLY AVAILABLE TO CUSTOMER WHO RETRIEVED A VOUCHER FROM THE WI BOOKLET 2013, THIS VOUCHER IS ONLY VALID ON SELECTED MODELS.
Surname: *
First name: *
Email: *
Telephone *
First line of Address *
Postcode *
Bank name *
Address of cash back delivery (someone must be present at time of delivery): *

NOTE: Please fill out this form online and send it to: lauren.abbott@gorenje.com. Cash back will be made by cheque within one month of receipt of this claim. The cheque has to be in the name of person claiming it. Please be sure to give an accurate address and do not forget to cash the cheque! The delivery will need to be signed for; therefore the address provided for delivery will need someone present at time of delivery. If there are any issues please contact Lauren on lauren.abbott@gorenje.com.

Your information will not be passed onto any third parties and is used purely for purposes of Gorenje UK Ltd.
This offer is only valid from 1st April 2013 – 31st July 2013.