Sylvania Stores & Cafe Shareholder Registration

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Community Share Registration Form

In order to purchase shares in Sylvania Community Stores Ltd. (a FCA-registered Community Benefit Society), please complete the form below, including necessary declarations. You must be aged 16 years or over to purchase shares.

Your contact details will only be used to communicate with you on matters regarding the business. We will not share your details with third parties. You may unsubscribe at any time.

Please also note that only one person can apply per form.

Your first name

Your surname

Your postal address inc. postcode

Your email address

Please check the relevant boxes to indicate you agree with the statements:

I am aged 16 or over

Please check to confirm

I have read the share offer prospectus and understand and accept the terms of the share offer and the rules of Sylvania Community Stores Ltd

Please check to confirm

I plan to apply for SEIS on my investment if approved by HMRC

Please check to confirm (non-mandatory)

I consent to the use of the e-mail address provided as the primary means of communication for official documents from Sylvania Community Stores Ltd

Please check to confirm

I will pay by electronic transfer. Please make payment to Sylvania Community Stores Ltd, Account No: 20440860, Sort Code: 60-83-01 and include the following text in your transfer description / reference: "SCS [Insert Your Initial & Surname]"

Please check to confirm

What value of shares would you like to purchase? (e.g. Type 100 if you'd like 4x shares at £25 each)

Note: There is a maximum shareholding of £6,000 (i.e. 240 shares)

Opt-in

I consent to the use of the e-mail address provided as the primary means of communication for official documents from Sylvania Community Stores Ltd

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