Lorenzi invites you to join the Premier Member Loyalty Programme.

HOW?
Merely complete the programme questionnaire below and Lorenzi will reward you with
the Premier Member Card which you will present with every purchase.

THE BENEFITS?
A 20% discount with every acquisition(with the excpetion of sale merchandise).
Invitations to seasonal launches abd previews of sale merchandise.

Thank You for your loyalty. We look forward to being your boutique of choice.

Please fill in the following form:
         
  Title:    
MR  MRS  MS  DR  PROF
 
  First Name:    
 
  Surname:    
 
  DATE OF BIRTH:    
 
  GENDER:     MALE   FEMALE  
  POSTAL ADDRESS:      
  CODE:      
  PHYSICAL ADDRESS:
(not a box number)		      
  CODE:      
HOME TEL NO:
  WORK TEL NO:      
  CELL NO:      
  e-mail:      
  YOUR OCCUPATION:      
  Your hobbies:      
  YOUR FAVOURITE COLOUR      
  SIGned:      
  DATE:      
         
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