Dinner Service self-referral form

Thank you for your interest in the Glass Door Dinner Service, we just need to ask a little bit of information about you. We are asking these questions so that we can safely administer you a place in one of our dinner services and so that we can report on the need of our service. All information will be kept in line with Glass Door’s Privacy Policy (see link in footer of website).

(Online referrals require a mobile number for SMS confirmation. If you do not have a mobile, please speak to staff or volunteers at one of our daytime drop-in services - https://www.glassdoor.org.uk/daytimesupport.)

Please note that if you are unable to attend on a night we are expecting you or wish to swap/attend extra nights, please call us. Unexpected absence may lead to us giving your place to someone else.