Student declaration


	[Click the Print button in your browser toolbar and then close this window] Please complete this form and send it with your order to:


		Forestfield Software Ltd 14 Warnham Road Horsham West Sussex RH12 2QU United Kingdom

	Student details:

Name
Address
Postcode		telephone
Country		Email


	Course details:

University or College
Faculty or Department
Course of study
Qualification
Expected or actual date
Course tutor or referee	A university or college official who can confirm your student status
Referee address


	Declaration:

I am a student undertaking / I have completed in the last six months ^*a course of study relating to nutrition. I wish to purchase Dietplan6 at the special student price. I accept that the software will be licenced for my own personal and professional use only and that the licence is not transferable to any other person.
Signature:	Date:	^*Delete as applicable