Bladon Community Pub Share Offer – Bladon Community Benefit Society

First Applicant Name *

First

Last

Company or Organisation (if applying on behalf of group or incorporated body)

Address *

Address Line 1

City

State / Province / Region

Postal Code

Country

Phone

Email *

Optional - Joint Application

I wish to make a joint application

It is possible to make a joint application, however only the first applicant will be listed on the members register and will have voting rights. If more than one member of a household wishes to invest and receive voting rights please complete one application form per person.

Joint Applicant Name

First

Last

Joint Applicant Address (if different from first applicant)

Address Line 1

City

State / Province / Region

Postal Code

Country

Joint Applicant Phone (if different from first applicant)

Joint Applicant Email (if different from first applicant)

Share Application

You have the opportunity to apply for 'A Shares' - withdrawable & interest bearing, or 'B Shares' - non-withdrawable & non-interest bearing, or a mixture of the two

A Shares - Withdrawable, Interest bearing shares.

I wish to become a member of Bladon Community Benefit Society in accordance with the Rules and apply for A Shares

Please enter the total amount in £ you wish to invest in A shares (must be a multiple of £50)

NB: Shares are priced at £50. If you live within a 5 mile radius of the White House Pub then the minimum investment is 1 share (£50), outside of this area the minimum investment is 5 shares (£250). The maximum permitted investment in A Shares is £50,000 and the maximum permitted investment in B Shares is £100,000.

B Shares - Non-withdrawable, Non-interest bearing shares.

I wish to become a member of Bladon Community Benefit Society in accordance with the Rules and apply for B Shares

Please enter the total amount in £ you wish to invest in B shares (must be a multiple of £50)

NB: Shares are priced at £50. If you live within a 5 mile radius of the White House Pub then the minimum investment is 1 share (£50), outside of this area the minimum investment is 5 shares (£250). The maximum permitted investment in A Shares is £50,000 and the maximum permitted investment in B Shares is £100,000.

Please tick the boxes to indicate that you agree with the following statements: *

I confirm that I am over 16 years of age

I have read the Share Offer Document and agree to be bound by the Terms and Conditions of the Share Offer and the Rules of the Society (see www.bladoncommunitypub.org)

I consent to receiving formal notices and links to documents on the Society’s website by email to the address above

I understand that the Management Committee of the Bladon Community Benefit Society Ltd may reject my application and are not obliged to tell me why it has been rejected

I confirm that I wish to invest, in the amount described in this application. I acknowledge that, by ticking this box, I am making a legally binding commitment.*

Method of Payment *

I am sending a cheque made payable to Bladon Community Benefit Society
I am paying by online bank transfer to: Unity Trust Bank, Sort Code 60-83-01 Account Number 20418494

Please include your initials and surname as a reference on bank transfer payments. Please return completed cheques as soon as possible to: The Treasurer, Bladon Community Benefit Society, 22 Grove Road, Bladon, Oxfordshire, OX20 1RD or hand it in at a launch event. The offer closes once the maximum target of £515,000 is reached or at the discretion of the Management Committee.

Data Privacy *

By requesting that I become an investing member of Bladon Community Benefit Society Ltd, I agree to my name, address, phone numbers, email address and the number of shares I wish to purchase being stored securely on a computer database. I understand that this information will be used solely for the purpose of maintaining a register of members as required by the rules of the Society, for the posting of notices regarding the activities of the Society and will not be passed to any third parties without your permission, except as required by law.

By ticking this box you are accepting the Bladon Community Benefit Society Ltd's Privacy Policy

Signed - Please type the full name of the first applicant *

Today's Date *

Holding shares on behalf of children and nomination of shares on death

You can choose to: A) hold shares on behalf of children and/or B) nominate a person to whom you wish your shares to be transferred on your death.

Optional - Holding shares on behalf of children

I wish to hold shares on behalf of children

If you ticked the box please fill in the relevant sections below. If you wish to buy shares on behalf of multiple children please complete multiple forms, 1 per child.

Child - Name

First

Middle

Last

Child - Date of Birth

Child - Address (if different from that of the first applicant above)

Address Line 1

City

State / Province / Region

Postal Code

Country

Optional - Nomination of shares on your death

I wish to nominate a recipient of my shares in the event of my death

You can nominate a person aged 16 or over to whom you wish your shares to be transferred on your death. Bladon Community Benefit Society Limited will respect your wish in so far as the law and our Rules permit. If you are a joint shareholder, your holding will pass to the other joint shareholder(s) on your death, unless you complete the form below. If you ticked the box please fill in the relevant sections below.

If you wish to nominate someone to whom your shares would be transferred on your death, please fill in that person's details below

First

Middle

Last

Address (if different from that of the first applicant above)

Address Line 1

City

State / Province / Region

Postal Code

Country

Nomination of shares on your death - acceptance of terms:

I understand that it may not be possible for Bladon Community Benefit Society Limited to action this request and I and my heirs will not hold the Society responsible for its actions.
I understand that these instructions can only be revoked or amended by my giving clear written instructions to the Secretary of the Society at its Registered Office.

Signed - Please type the full name of the first applicant *

On submission of this form you will see an on-screen confirmation and receive an email copy of your completed form. If you do not see the confirmation it is possible your form has not correctly submitted. In that case, please try again or contact us to verify via treasurer@bladoncommunitypub.org