UK Membership Form

I would like to join the Arbuthnott Family Association.
Other than that which I specify below and conscious of the Data Protection Act 1988,
I agree that data concerning me may be held on computer and that it may be put on the website.

I enclose �35 for my Lifetime subscription
              �5 for my first year's annual subscription (�5 each year thereafter, revisable)

Full Name ...................................................................

Address: .....................................................................

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

Telephone (home) ......................................................

Telephone (work) .......................................................

Email                    .......................................................

Table No (if known) ...................................................

Occupation            ......................................................

How did you hear of us? ..............................................

Your website (if any) ....................................................

Photograph on the net ...................................................

Signature                    ...................................................

Date                          ...................................................

Please complete and return to
Charles Robert Arbuthnott 7A Woodhall Bank, Colinton, Edinburgh, Scotland EH13 OHL

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