Order AfriForum 911 wristbandsPlease complete the details and membership number of the principal AfriForum member (it is a nine-digit number printed on your membership card) below to order additional AfriForum 911 wrist bands. Each additional wrist band costs R10. Please do not complete a separate order from for each wrist band.All fields marked with * are compulsory.Name** First Last Membership*(Phone our service centre at 086 10 200 30 if you do not yet have a membership card.)Cell number**Email address Full delivery addressImportant: Delivery takes between six and eight weeks.Name of complex / old-age home / businessStreet number and name / P.O. Box**SuburbCity / townPostal code**ProvinceWrist band/sAdjustable WristbandsAdjustable Wristbands Price: R10.00 QuantityPlease indicate the number of wrist bands that you would likeAmountAmount R0.00 * I authorise AfriForum to include the amount together with my next debit order payment. NameThis field is for validation purposes and should be left unchanged.