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Changing your name or address
Address
Dates
To inform us of a change in your name or address, please use the following form.
Please provide the subscription number printed on the magazine label if available. (see example in bold below).
4567000891012
10/10/09 X
MR. MAX READER
INFORMATION STREET 16
70 612 PAGE TOWN
Please provide your "old" address as well as your new name and address details.
Current address:
Title
:
Please choose
Mr.
Mrs.
Ms.
*
Name Line
:
*
Address line 1
:
*
Address line 2
:
Postal Code
:
*
City
:
*
Country
:
*
New Name/Address Details:
Title
:
Please choose
Mr.
Mrs.
Ms.
*
First Name
:
*
Last Name
:
*
Address line 1
:
*
Address line 2
:
Postal Code
:
*
City
:
*
Country
:
*
Phone
:
E-Mail
:
*
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.
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