Become My Friend | Thomas Tooth Mouse

BANKING DETAILS:

Business Works
ABSA, 9218817058;
Branch code: 632005

Send your proof of payment to:
info@thomastoothmouse.co.za
or fax to 086 577 5544

Thomas Tooth Mouse Subscription

Become My Friend

Give your little one a pleasant start to dental care!
Spoil your child / grandchild / family child with a letter, story and activity from the Tooth Mouse every month!
Subscribe him / her to my pen-friend club for only
R70-00 per month!

To subscribe, please fill out the online form below

Required *

Where did you hear about Thomas?

Details of Parent:

Name and Surname: *

Email Address: *

Details of Child:

Name and Surname: *

Date of Birth: *

Postal Address: *

Country: *

Boy / Girl? *

Choose Payment Option:

Payment Option 1: R70-00 per month per Debit Order.
Download Debit Order Form icon here (67.21 kB)
Complete the form and send it back to us via email or fax.

Payment Option 2: 6 months upfront payment per Direct
deposit – R400-00. (save R20-00) - see banking details on the left

Option 1 or 2 ? *

THOMAS TOOTH MOUSE CANNOT POST ANY ENVELOPE WITHOUT RECEIVING YOUR PROOF OF PAYMENT FIRST !