Welcome to Doklao Korats

Membership Application Form

Name/Contact:

Salon/Company:

Address:

State:

Postcode:

Phone:

Mobile:

Fax:

Email:

TICK ALL APPLICABLE BOXES

I intend to provide product

I would like to offer my time to cut hair

I intend to provide a gift certificate

I'd like to help with the promotional aspect of the programme

The following services will be assisted

(please tick a preference if you have one)

On behalf of the young people ‘in care’ that will be involved in this programme,

thank you for your contribution, as it is greatly appreciated.