Membership application

Structure Wellness Limited
FCA registration no. 9648
8 Stevenson Square, Manchester, M1 1FB

I wish to become a member of Structure Wellness Limited and apply for one share of £1. I support the objects of the society and agree to be bound by its rules.

1. Applying as

An individual (aged 16 or over)A company or other corporate bodyNominee of an unincorporated group

2. Your details

Full name

Address

Postcode

Phone

I confirm I am aged 16 or over

3. Organisations only

Organisation name

Registration no. (if any)

Type of organisation

Name of representative / nominee

Corporate members: please attach the resolution of your governing body appointing your representative (Rule 12).

4. Communication

I'm happy to receive notices and papers by email

You can change this at any time by writing to the Secretary (Rule 108).

5. Payment of £1

CashBank transferCheque payable to Structure Wellness Limited

Bank transfer reference used

Date paid

6. Declaration

I support the objects of the society, apply for one £1 share, and agree to be bound by the society's rules.

Signature

Date

Your details are kept in the society's register of members, which the law requires us to maintain. We use them to run your membership and send you notices. We won't share them for marketing.

Office use only

Date received

£1 received (date)

Board decision date

Member no.

ApprovedRefused (applicant given chance to respond)Entered in registerCopy of rules given

Structure Wellness Limited · Community Benefit Society · FCA no. 9648