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Please print this page and after completion send with your remittance to the address below.

Seavington Community Shop and Services Association

Registered by the Financial Services Authority No: 30220 R

Application to purchase one share in the Association

I hereby apply to purchase a single £5 share in the Seavington Community Shop and Services Association and thereby become a member of the Association and agree to abide by the rules of the Association.

Mr / Mrs / Miss* ......................................................................................(family name)

 

..............................................................................................................(given names)

 

Address ......................................................................................................................

 

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

 

........................................................................... Postcode .......................................

 

e-mail ...................................................................Telephone .....................................

* Please delete as required

 

I attach my payment of £5 plus £....... donation* to the Association's funds making a total

payment of £.......

* A donation is entirely optional but will be of great assistance

Please make cheques payable to: Seavington Shop Association

Send your completed form and payment to;

Seavington Shop Association,

Middlefield Barn, Church Lane, Seavington St Mary, Ilminster, TA19 0QP