Please tick the relevant box for your membership subscription to Friends

of John Muir’s Birthplace (Dunbar’s John Muir Association)

Annual
Subscription

Membership
Category

Donation
£

£5 [ ]

Ordinary

[

]

£8 [ ]

Family: 2 adults + children living at
same address

[

]

£3 [ ]

Concession: pensioner/unwaged/
student.

[

]

£25 [ ]

Affiliate: Voluntary organisation or
group

[

]

Name(s):

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

Address:

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

...........................................................................................................
...........................................................................................................
Postcode ................................ Tel: .................................................
Email:

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

I enclose a cheque made payable to DJMA for £……
or [ ] payment by standing order has been made.
Please send completed forms and subscriptions to:

Membership Secretary, DJMA, c/o John Muir’s
Birthplace, 126 High Street, Dunbar, EH42 1JJ
Gift Aid Declaration
I want the Friends of John Muir’s Birthplace to treat all
subscriptions/donations I make from the date of this
declaration, until I notify you otherwise, as Gift Aid
donations.
Signed: ....................................... Date: ...................

!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!""!

Friends of John Muir’s Birthplace – Subscription

Dunbar’s John Muir Association: Standing Order
Please complete and forward to your bank. Alternatively, use the details of the
DJMA Account Number, Sort Code, and Reference to submit via an online banking
system.

To:-

(Bank name and address) ..........................................................

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

From:-

(Own name and address) ......................................................

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

My Account Number: .......................................................
Bank Sort Code:

...... -.......- ......

Please pay to the account of Dunbar’s John Muir
Association the sum of £……. on receipt of this instruction
and further annual payments of the amount (£…….) on the
first day of April/September* each year until further notice.

Signed: ....................................... Date: ...................
----------------------------------------------------------------------------BANK USE ONLY Please pay:Dunbar’s John Muir Association, Bank of Scotland,
95 High Street, Dunbar, EH42 1ER
Account Number: 00175880 Sort Code: 80-13-28
Quoting reference: SUB
*

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