_Personalised Voluntary Service Bonus Code Application

_In the comment section you need to provide your address, telephone numbers and details of the voluntary work and service you do  and the relevant organisations and groups to which you belong. By transmitting the completed form to Dr Ross Perry you acknowledge that it remains totally at Dr Ross Perry's discretion as to the nature and frequency of any bonuses and/or discounts and/or special promotions that he may apply or offer when I need to avail myself of his personal attention, help, advice and/or recommendations.