Forename:

Surname:

Position:

Vet

Nurse

Receptionist

Choose the
following:

New registration

Clinic Name:

Update details

Please tick if your clinic is part of a chain or group:

Clinic Address:

Practice Manager

Other
Opt-out of scheme

Group / Chain Name:

Postcode:

Clinic Contact
number:

Email address:

Pet Number 1
Canine

Feline

Hills Brand fed:

Pet Weight:
Science PlanTM

Specific product:

Coupon size
required:

1.5kg 3.5kg bag

Species:

VetEssentials

Prescription DietTM

Ideal BalanceTM

4kg 8kg bag

10kg 15kg bag

Wet Food

Pet Number 2
Canine

Feline

Hills Brand fed:

Pet Weight:
Science PlanTM

Specific product:

Coupon size
required:

1.5kg 3.5kg bag

Species:

VetEssentials

Prescription DietTM

Ideal BalanceTM

4kg 8kg bag

10kg 15kg bag

Wet Food

Please submit your form using one of the following options:

Email: Scan in your completed form and email to sfs@n2vis.com,
Fax: 01992 446840 or +44 (1992 446840) ROI,
Post: SFS processing, c/o N2 Visual Communications Ltd, Unit C Foxholes Centre, John Tate Road,
Hertford, SG13 7DT, UK
Your personal data is collected on behalf of HillsTM Pet Nutrition Ltd. We will store your data in our databases and use it for marketing purposes, e.g.
newsletters, offers, surveys and other
information by email. Provision of the personal data is voluntary. Collected personal data may be shared within Hill's Pet Nutrition group of the companies and
the service providers processing the
personal data on our behalf. Some of them may be located in non-EU countries, so you also agree with the transfer of your personal data outside of EU. Your
personal data is only processed in
compliance with the applicable laws. You have the right to access your personal data stored by us, rectify, erase and object, as well as other rights provided for
in the Data Protection Act.
I agree with processing of my personal data and would like to receive further information from Hill's Pet Nutrition
Terms and Conditions:
1. Clinic staff member must be employed by veterinary clinic
2. Maximum of 2 coupon sheets supplied per member of staff (2 pets)
3. Maximum of 6 coupons will be issued per coupon sheet
4. Staff member can redeem coupon against any Science Plan, Science Plan VetEssentials, Prescription Diet or Ideal Balance product/s subject to Terms

and Conditions of voucher

5. 2015 Scheme runs for 1 year, but staff member might need to register on-line for the remaining 6 months of the year
6. Proof of purchase must be provided with coupon for reimbursement to take place
7. Please allow 4-6 weeks for coupon reimbursement
8. Will display Feed and Recommend POS within the clinic