The Open Door

Application to Join the 200 Club

Name: _____________________________________

Address: _____________________________________

_____________________________________

Postcode: _____________________________________

Telephone: _____________________________________

I should like _______ numbers at £12 each

I enclose cash/cheque for £ __________

Please make cheques payable to The Open Door Edinburgh. Please do not send cash through the post.

□ Please send me information about the Friends of The Open Door scheme

Signature: _____________________________________

Date: _____________________________________