I would like to be a Friend of UKAN

Name............................................................................................................

I enclose a one off payment of..............................(suggestion £20) (Cheques should be made payable to UKAN)

I would like to make a regular contribution by standing order Yes / No (We will contact you about this)

Postal address.............................................................................................

...................................................................................................................

...........................................................................Postcode  .......................

Telephone no..............................................

Email address...............................................................................................

Please print this form, fill it out, and return to UKAN, C/O 8 Beulah View, Leeds, LS6 2LA.

UK Advocacy Network is a company limited by guarantee. Registered in England number 3796174. Registered office: 14 - 18 West Bar Green, Sheffield, S1 2DA. Registered as a Charity No. 1077676.