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To become a Friend of Grand Union, please complete the form below. If you require any assistance to complete your form, call the office on 0208 981 1551 or email supportus@grandunion.org.uk

* 1. Full name:

* 2. Contact Telephone number(s)

* 3. Contact Address and Postcode

* 4. Email Address

* 5. What kind of donation would you like to make?

* 6. If you are a UK Tax Payer you can allow Grand Union to claim back the tax paid on the money you give us, increasing your donation by almost a quarter with no extra cost to you.

* 7. Would you like your email address to be added to our regular mailing list?

* 8. How did you hear about becoming a Friend of Grand Union?

Thank you for completing your form to become an Friend of Grand Union. Before you finish, please confirm and date your online form.

Once you submit the form you will be contacted by a member of our team.

* 9. Please tick this box to confirm the details within this form are correct and that you are happy for Grand Union to use this information for the purposes of the Friend of Grand Union scheme. By ticking this box you also confirm that Grand Union can contact you about finalising your payment to the scheme.

* 10. Date (DD/MM/YY)