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Friends of St Andrew’s House

Registered Charity Number 214293



Application

Yes, I wish to become a Friend of St Andrew’s House and I enclose my annual donation of

£……………………………..

Full Name …………………………………………..

Address …………………………………………..

…………………………………………………………..

…………………………………………………………..

Postcode …………………………………………..

Telephone …………………………………………..

Signature …………………………………………..

Date …………………………………………..


Note: If you also complete a Gift Aid Form we can reclaim the tax on your donation.


Please return this form to the Charity Secretary, St Andrew’s House,
19 St Andrew’s Road, Earlsdon, Coventry CV5 6FP