Membership and Gift Share Acceptance form

Long Lands Common Limited

A Society Registered Under the Co-operatives and Community Benefit Societies Act 2014 - Society Number: 8326

This is an application to become a member of the Community Benefit Society Long Lands Common Limited. This form is for individuals who a) bought their shares through the Crowdfunder page, or b) are the recipients of gift shares bought for them by another individual.

Any individual aged 16 or over may apply to become a member of Long Lands Common Limited.

All members must be shareholders and all shareholders must be members.

Your details:

First name (s)

Last name

Address

Post code

Phone

I have bought or am accepting shares to the value of:

Your acceptance will be acknowledged, share certificates issued, and your name put on the membership register. Please bear with us during this process as we are all volunteers and are processing a substantial number of applications.

* Before filling in the agreement below you are advised to go to https://www.longlandscommon.org/downloads to read the share offer document and the rules of the Community Benefit Society (Long Lands Common Limited). If you wish to view a paper copy, please contact us – details below.

Correspondence address: Membership Secretary, Long Lands Common Limited, 12B Regent Street, Harrogate, North Yorkshire, HG14BE.

Email: info@longlandscommon.org

Telephone: 07760 135503 and leave a message.

Agreement:

I am aged 16 or over.

EITHER: I am already a member of Long Lands Common Limited as I already own shares.

(Please give your membership number if you know it.)

OR: I wish to become a member of Long Lands Common Limited󠆎. (This is obligatory if you are to become a shareholder.)

I acknowledge that I have read the share offer document and understand the terms and conditions of the offer, including the risk factors pertaining to this offer.󠆎 See above for how to find this document.

I am bound by the terms & conditions included in the share offer document and by the rules of Long Lands Common Limited, which can be viewed at https://www.longlandscommon.org/downloads

(If you wish to view a paper copy, please contact us – details above.)

I understand that the board may reject my application and is not required to inform me of the reasons.󠆎

I understand that the data on the form I provide will be stored in an electronic database and will only be used by Long Lands Common Limited, and will not be shared with other third parties. Details of our Privacy Policy can be found here: https://www.longlandscommon.org/downloads/

I give my permission for Long Lands Common Limited to contact me with formal documents via email, and to contact me as relevant to its activity.󠆎

I agree to being contacted by Long Lands Common Limited, via email campaigns and newsletters, about events and activities.󠆎

I understand that the Society may, at its absolute discretion, require proof of identity from any person seeking to invest.󠆎

Please specify what you would like to happen to your shares in the event of your death:

EITHER:

Donate them to Long Lands Common Limited󠆎.

If you have ticked this box, please sign here:

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OR: Transfer the actual shares to a named person (i.e. they become a shareholder).

Their names:

Their Email (for actual shares)

Their address:

OR: Transfer the value of the shares to a named person (i.e. they inherit the value of the shares, which are then withdrawn from the Society).

Their names:

Their Email (for value of shares)

Their address:

NB If your named person(s) is currently under 16 they must be over 16 at the time of your death to receive the actual shares. If they are under 16 at the time of your death they will receive the value of the shares instead.

Signed as a deed:

Type your name:

Signature:

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