REPLACEMENT ID CARD ORDER FORM

1
Please be aware that due to the high cost of producing our ID cards there is a £30 fee to order a replacement.
2
Name* This field is required.
First Name
Last Name
3
Email* This field is required.
example@example.com
4
Please enter your HPAC registration number* This field is required.
5
Reason* This field is required.
6
Do you want to update your ID photo?
YESNO
7
Upload the ID photo you would like to useEnsure your photo meets the requirements here: https://hpac-uk.org/id-card-requirements
Drag and drop files here
Select files to upload
Cancelof
8
Do you still have your old ID card?
YESNO
9
Please upload a faceup image of your old ID card cut into four equal piecesThis must be done before we can issue a replacement. Thank you.
Drag and drop files here
Select files to upload
Cancelof
10
HPAC ID CARD* This field is required.
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My Bag
1
My Bag
Great Product Name
$20
Quantity:1
Size:Small
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Great Product Name
$20
Quantity:1
Size:Small
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Great Product Name
$20
Quantity:1
Size:Small
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Great Product Name
$20
Quantity:1
Size:Small
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ORDER SUMMARY
Total costGBP
REPLACEMENT IDENTITY CARD
£30.00+Edit
Back
Total cost £0.00
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
11
* This field is required.
Should be Empty: