Your Details

If you do not have an email address, please contact us on 0121 630 3678 to ask for a paper form, or ask in the shop.

First Name

Last Name

Email address

Telephone (no spaces)

Address

Postcode

To give us a backup method in case of difficulty with matching payments to new Members, we request that you provide here the last three digits of your bank account number (optional but preferred)

Share Details

*I wish to become a Member of YSCSL in accordance with the Rules and apply for shares to the value of:

Share Value (do not include £ sign)

* Shares cost £1 each. The minimum shareholding is £100 (including for Share Save participants) and the maximum is £20,000.

I wish to participate in the Share Save scheme to enable me to reach the minimum investment (£100) within twelve months. PLEASE NOTE: the Share Save scheme is only applicable to the minimum share amount of £100.

I wish to include an additional gift of £

Any amount is welcome. If you wish to make a gift without purchasing shares, please contact us at shareoffer@yorksuppliesco-op.co.uk or 0121 630 3678 or ask in the shop.

Purchasing on behalf of an organisation

If you are applying for shares on behalf of an incorporated or unincorporated organisation, please supply the following additional information. Please note, this form must be signed by a Director or Officer of your organisation.

Organisation Name

Registered Company Number (if applicable)

Name of Signatory

Position in Organisation

Your data

York Supplies will be developing a programme of community activities. Please tick here if you would like to volunteer to help with these in any capacity.

In addition to the communication that we are required by law to undertake with our members, we may also provide regular updates by email. Please indicate whether you are happy to receive these additional emails here. You can also unsubscribe from these emails at any time

Your personal details will be treated according to our privacy policy, which is available on our website. You may also request a paper copy by calling 0121 630 3678.

Share transfer

I understand that it may not be possible for YSCSL to action this request. I understand that these instructions can only be revoked or amended by my giving clear written instructions to the Secretary of the YSCSL at its Registered Office. I understand that trustees will need to be appointed if my nominee is under 16 years of age.

I wish to nominate a person to whom I wish my shares to be transferred on my death.

Nominee’s full name

Address

Postcode

Telephone

Email

Agreement

• I have read the Share Offer Document and Business Plan, including the risk factors pertaining to this offer
• I wish to become a Member of YSCSL
• I agree to be bound by the terms & conditions included in the Share Offer Document, and by the rules of YSCSL
• I consent to receiving formal notices by email (unless you need to have postal communications)
• I understand that the Board of Directors of YSCSL may reject my application and are not obliged to tell me why it has been rejected.

Tick here to confirm your agreement

Applications are not complete until you click on the Submit button. Please submit this completed application form before 7 September 2023.