Please Click Here to Print This Page
Subscriptions... 
[logo] ...Memberships

We need your help

You can assist our humanitarian work and also receive the best information on choices for a dignified death by becoming a member of Exit. You will receive an information pack, our world renowned journal, a free living wills set with instructions, and (if you are over 21 - please enclose proof) the option to apply for the booklet Departing Drugs or the leading new self-deliverance manual,  Five Last Acts 2nd edition at a special reduced price (these are not included in the cost of membership). All information is held in strictest confidence and your details will not be disclosed to any third party. Exit works with minimal resources servicing worldwide enquiries. Allow up to 12 wks for processing.

Rates:   UK: minimum £30;Overseas: minimum £50
Please note: British currency only please. Additional notes & advice on payment click here. Life membership: ten times the annual rates.

You can also become:
A Supporter £50 p.a.min. (Overseas £100). A Benefactor £100 p.a.min. (Overseas £150); A Donor £250 p.a.min. (Overseas £300).   A Sponsor £500 p.a.min. (Overseas £550);
Supporters, Benefactors, Donors & Sponsors, as well as free membership and our Journal, optionally receive a listing of thanks in the Journal.

PLEASE PRINT THIS PAGE (or copy the relevant details) and send it with your cheque to: Exit, 17 Hart Street, Edinburgh EH1 3RN Scotland, United Kingdom.

Mr/Mrs/Ms/other ........ First name.................................... Second name (Surname).........................................

Address...................................................................................................................................

....................................................................... DATE ..................

Postcode/Zipcode................................... Country.................................................

Tel no: (optional)................................. Email (optional)...........................................

Occupation or former occupation........................................ 

Date of birth......................................

Subscription £.......... Donation £.......... TOTAL ENCLOSED £...........

Please debit my Visa/Mastercard £............. Expiry date ............................  

Card number .... .... .... ....     .... .... .... ....     .... .... .... ....     .... .... .... ....

Security code (last three digits on reverse of card)   .... .... ....

Signed ........................................................................

Click Here to Print This Page

Please note: We process orders as quickly as possible but we are NOT an emergency service and do not give one-to-one advice (other than in literature or at workshops). The demands of our work and limited resources mean that applications may take up to 12 weeks to process at times. We do not 'fast track' applications on request. Your card / cheque will not be debited or processed until your order is being sent out.


Thank you

Copyright ©: 1998-2010 Chris Docker. URL: http://www.euthanasia.cc/new_app.html
[Return to Fast Access] [Email]