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Member
Scheme Member Name
Police Federation Member
Offer Text
Preamble
Please complete your details below and a member of our team will be in touch ASAP.
Content
Title
(Value Required)
--Select--
Mr
Mrs
Miss
Ms
Dr
Prof
Rev
First Name
(Value Required)
Last Name
(Value Required)
Email
(Value Required)
Mobile Phone
(Value Required)
Home Phone
Organisation
Preferred Term (in months)
(Value Required)
18
24
30
36
42
48
Initial Payment / Rentals in Advance
(Value Required)
1
3
6
9
12
A higher number of rentals in advance will reduce your monthly rental payment.
Expected Annual Mileage
(Value Required)
5000
6000
7000
8000
9000
10,000
11,000
12,000
12,500
13,000
14,000
15,000
16,000
17,000
18,000
19,000
20,000
21,000
22,000
23,000
24,000
25,000
26,000
27,000
28,000
29,000
30,000
31,000
32,000
33,000
34,000
35,000
36,000
37,000
38,000
39,000
40,000
Comment
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Notes
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