Yarpole Shop account application form.

Yarpole Shop account application form.

(Yarpole Community Shop Association Ltd). Registration No: 29911R. Registered with the Financial Conduct Authority.
I wish to apply for a customer account with Yarpole Community Shop Association Ltd. (“the Association”)

I undertake to settle my account in full by the fifth working day of each month following applied transactions.

I understand that the Association may withhold account facilities at any time and request full repayment if, in its opinion, the facility is being misused.
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityCounty

Postcode
Phone Number*

Area CodePhone Number
Email*
example@example.com
We need proof of your identity. Please upload a scanned copy of your passport, driving licence or a recent utility bill.

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When your application has been approved please let the volunteer know when you wish your purchases to be applied to your account. You will receive a receipt detailing your purchases and showing the opening and the new balance of your account.

Please pay off your account in full each month. We would appreciate you making a BACS transfer to the Shop. Details are available on the Shop page of the Yarpole website.
Please verify that you are human*
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