Community Share Offer Application Form

In accordance with the rules of Colne Valley Equitable Care Society Limited, I apply for shares to the value stated below. The minimum investment is £50, the maximum investment is £15000.

Select an appropriate amount, or choose 'other amount' and key in the value of shares you wish to apply for without a comma (e.g. to apply for £4,000 worth of shares simply enter 4000).

If you wish to apply on behalf of an organisation or corporate body, please tick the relevant box below and provide details both for yourself as the initial point of contact, and for the organisation.

Total Amount
On Behalf Of Organization
Your details
Please enter your date of birth using the format dd/mm/yyyy – or use the pop-up date picker to select the correct date.
Please provide both a phone number and an email address wherever possible so that we can contact you.
For individual applications only: In the event of my death I nominate the following to receive the value of my shares.
*in the event of your death, or if you die before 31st August 2025, at the end of Year 5 (whichever is the later event) your investment will be paid to your legal representative on production of either a Grant of Probate/Letters of Administration or a Statutory Declaration confirming the identity of the person entitled to your estate under the Small Estate Act.
Payment Options
[x] I will send payment via bank transfer (BACS) or cheque following submission of this form. (Details will be emailed to you immediately.)

I confirm that:

  1. I have read the Share Offer Document, including the Risk Statement at the beginning of the document.

  2. I wish to become a member of Colne Valley Equitable Care Society Limited.

  3. I agree to be bound by the Terms and Conditions included in the Share Offer Document and the Rules of Colne Valley Equitable Care Society Limited.

  4. I understand that the Board of Directors of Colne Valley Equitable Care Society Limited may reject my application, and are not obliged to tell me why it has been rejected.

  5. I consent to receiving formal notices by email and links to formal documents on the Colne Valley Equitable Care Society Limited website. To reduce our administrative costs, we would like to be able to send you formal notices by email and refer you (by email) to documents posted on our website.

  6. I consent to the use of my personal data in accordance with the Terms and Conditions stated below.