Assel Valley Community Renewables Society - Registration number 7834 I apply to be a member of and wish to invest the total amount shown below in Assel Valley Community Renewables Society on the Terms and Conditions of the Offer Document dated 1st March 2019 at the price of £1.00 per Share.

Amount To Invest * You must invest at least £250 but not more than £30,000.



Please enter the figure without a pound sign. Please enter a number from 250 to 30000.

Applicant Details

Title * Title (Mr/Mrs/Ms/other)

Forenames *

Surname *

Address line 1 *

Address line 2

Town *

County

Post Code *

Date Of Birth *

Email Address Enter Email Confirm Email

Main phone number *

Alternative phone number Add your mobile or evening phone number (optional)

Application Type * Are you applying just for yourself, or as a nominee for a child Self Only

Nominee for a child

If Applicant is nominee for a child

Child's Forenames *

Child's Surname *

Child's Date Of Birth *

Child's Street Address * Enter the child's address if different from that given above

Child's address line 2

Child's Town *

Child's County

Child's Post Code *

Payment Details

Payment Type * If paying by electronic transfer through the banking system please pay into Assel Valley Community Renewables Society Ltd bank account quoting your surname and date of birth as a reference.



Account details: account number 34212348 , Sort Code 40-51-62 I have paid by bank electronic transfer or BACS to 'Assel Valley Community Renewables Society Ltd'

I will send a cheque or bankers draft crossed A/c Payee to the value indicated above, payable to 'Assel Valley Community Renewables Society Ltd'.

I understand that the cheque supporting this application will be presented for payment following receipt and I warrant that it will be paid on first presentation. I have written my address on the back of the cheque.

Assel Valley Community Renewables Society have chosen to bank with Handelsbanken an ethical bank committed to offering local relationship banking to communities across the UK. They are a wholly owned UK subsidiary of the Swedish Svenska Handelsbanken AB.

Share Interest Payments Assel Valley Community Renewables Society will pay share interest by electronic transfer via BACS. In order to receive your share interest please provide the following details:

Bank Account Number

Bank Sort Code

Name on account

How did you hear about us? Energy4All

Friends & Family

Social Media

Carrick Gazzette

Ayr Advertiser

The Herald

Co-op News

Other (Please Specify)

Other (Please specify)

Notices by email and documents on our website To help reduce paper costs (and CO2 emissions), Assel Valley Community Renewables Society and Energy4All would like to send you notices and information by email and refer you (by email) to documents posted on the Assel Valley Community Renewables Society website. By completing this form you are consenting to receiving such notices by email and accessing documents through the website.