Share Form

Community Share Application Form
Name

First NameLast Name
Value of Shares I wish to purchase*
Minimum £10
Email
example@example.com
Address

Street Address

Street Address Line 2

CityCountry

Post CodeCountry
Phone Number
Please enter a valid phone number - no spaces.Format: 00000000000.
Phone Number (non UK)

Country CodeArea CodePhone Number
I am purchasing for myselfI am purchasing as a gift
Enter the name of the recipient (first and last name only) - they must be 16 or over.
Address of recipient

Street Address

Street Address Line 2

CityCountry

Post CodeCountry
By buying these shares, I agree to all the information disclosed here being held on a computer database in compliance with the General Data Protection Regulation (GDPR). I understand that this information will be used by Cotherstone Old Chapel Project Limited only and will not be passed to third parties.I agree that I can be contacted by the The Cotherstone Old Chapel Project Limited using the email address given above
I have read the share prospectus and understand and accept the terms of the Share Offer and Rules of The Cotherstone Old Chapel Project Limited.I wish to become a member of The Cotherstone Old Chapel Project LimitedI am over 16 years of ageI will give proof of my identity & address, if necessary, for anti-money laundering purposes.I understand that the Committee may reject my application and are not obliged to tell me why it has been rejected.
I wish to pay by bank transferI wish to pay by cheque
Please make payment to:

Account name: The Cotherstone Old Chapel Project

Sort Code: 608301

Account no: 20447999

Reference: Your name + “Shares”.

Please double-check that the account details are correct before you submit your payment.

International payments should use the Swift Code (BIC) NWBKGB2L, IBAN Number GB93NWBK60023571418024
Please send a cheque made payable to The Cotherstone Old Chapel Project to:

Chris Tarpey
COCP
1 East Briscoe
Baldersdale
Barnard Castle
DL12 9UL
Should be Empty:

Community Share Application Form