Application for Membership of Curry Mallet and Beercrocombe Community Pub Limited

Shares cost £1 each, minimum purchase 100 shares.

Applicants must be over 18.

If you are applying as a company, group or organisation please nominate an individual to represent you

Declaration

• I have read the Share Offer Prospectus.

• I am over 18.

• I wish to become a member of Curry Mallet and Beercrocombe Community Pub Limited, a Community Benefit Society registered with the FCA.

• I agree to be bound by the terms and conditions included in the Share Offer. Prospectus and the Rules of Curry Mallet and Beercrocombe Community Pub Limited.

• I understand that the Management Committee of Curry Mallet and Beercrocombe Community Pub Limited may reject my application and are not obliged to tell me why it has been rejected.

• I hereby authorise to make such enquiries as are deemed necessary to confirm the eligibility of this Application. The Applicant shall provide all additional information and documentation requested by the Society in connection with this Application, including in connection with money laundering, taxation or other regulations.

• By supplying my contact details I agree to be contacted by the Society with news and updates and understand that my personal details will be used and stored according to the data protection act.

Preferred method of payment:

Please pay by bank transfer (BACS) to

Curry Mallet and Beercrocombe Community Pub Limited

Co-operative Bank

Sort code: 08-92-99

Account number: 67417746

Please add a reference: First three letters of first name and first three letters of surname.

e.g. Martin Scaman would be MARSCA.

Alternative method of payment

Cheques can be made payable to Curry Mallet and Beercrocombe Community Pub Limited.

Money raised will be held in the bank account and will only be accessed when the committee

concludes that there are sufficient funds to complete the project. Funds are accessible only

by the Secretary and the Treasurer. Cheques (if enclosed) supporting this application will be

presented for payment upon receipt.

Please send your completed application form and cheque (if applicable) to:

Secretary

Curry Mallet and Beercrocombe Community Pub Limited

Fairmead House

Curry Mallet

TA3 6SY

Data protection

For details of our Privacy Policy please see our website www.cmbcommunitypub.com

In the event of my death I nominate the following person to receive my shares