Friends of Ellisland
Membership Application Form
Please fill out the form below, click print and send it to the following address:
Betty Haining
Friends of Ellisland
Honorary Treasurer
74 Laghall Road
Kingholm Quay
Dumfries
DG1 4SX
Title (Mr, Mrs, Miss, Ms etc.)
First Name(s)
Surname
Address
Post Code
Telephone
Type of membership
Single £8.00
Family £10.00
Corporate £50.00
Payment Type
Cheque
Standing Order
Bank Details
Bank Name
Bank Address
Bank Post Code
Bank Account Number
Branch Sort Code
Signature...............................................
Date......................................