DVD - Fight Back Form

Please print and then Fill in this form for the DVD - Fight Back

Complete and return this form to: -
National Ankylosing Spondylitis Society
Registered charity no 272258
Unit 0.2
One Victoria Villas
Richmond
Surrey
TW9 2GW

E: admin@nass.co.uk

I wish to make a donation to NASS - Donation £..............

Please make the cheque payable to "National Ankylosing Spondylitis Society"

(BLOCK LETTERS: ADD MR/MRS/MISS OR OTHER TITLE)

Date ...................................

Surname .....................................................................................................

Other names or initials .............................................................................

Address ..............................................................................................

Post code ..............................................

Telephone number: Home....................

Do you suffer from Ankylosing Spondylitis?* ..........................................

*This question is asked so that we know what proportion of sufferers

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This is a very useful guide for all who have AS and especially those who are remote from regular, supervised physiotherapy sessions.

The DVD is region free, so it will play on any DVD player.