Cycle Solutions - Order

Title
Please select one: ------------------------------- Mr Mrs Ms Dr Prof Other

Name 

Email 

Address

Postcode 

Area  
Please select one: ------------------------------- Scotland Northern Ireland North East North West Midlands Wales London South East South South West

Phone number 

Company 

Cycle Choice 

Cycle RRP (£) 

Accessory Choice 1

Accessory 1 RRP (£)

Accessory Choice 2

Accessory 2 RRP (£)

Accessory Choice 3

Accessory 3 RRP (£)

Other Items Required

Other Comments

IMPORTANT – USE OF YOUR OWN INFORMATION

By submitting this form you agree to Wheelies Direct Cycle Solutions Ltd using and sharing your information in the following ways. Wheelies Direct Cycle Solutions may hold your information on computer or otherwise. Wheelies Direct Cycle Solutions will use your information in connection with the administration of our Cycle Solutions scheme and the supply of cycle equipment under it. Wheelies Direct may disclose your information: 1) where it is required to or allowed to do so by law; 2) to your employer; 3) to the manufacturer or other person who supplies the equipment and to the provider of any maintenance or support services in relation to it. You have the right to receive details of certain information Wheelies Direct Cycle Solutions holds about you if you apply to Wheelies Direct Cycle Solutions in writing. A fee will be payable. Wheelies Direct Cycle Solutions may wish to contact you from time to time with information about products and services that it or other businesses may offer.

Please tick whether you are happy to be contacted by Wheelies Direct Cycle Solutions for this purpose