Application for Occupational Membership

I ...................……………………………........................................……………………………………………..... of (Home Address)………………………………………………………………………………………………................. ……………………………………… …………………………………………………………………………........................... …………………………………………………………………………………………...................................……..…… ....

apply for occupational membership of the Bridgwater & District Credit Union and declare that I qualify by employment in Bridgwater. Employers Name ………………………………………………………………………………...............………………… Address…………..….……………………………………………………………................................................... .…………………………………………………………………………………………………………....................…………….. ………………………………………………………………………………………………..…....................…………………….

This is my paid occupation/a voluntary unpaid position * Please delete as appropriate. I have been employed by this Company/Organisation Date …………………………

for…………….years…………… months

Applicants Signature ……………………………………………………

Statement by Employer. I certify the above statement is correct and that the applicant has been employed by

Company/Organisation ……………………………………………………. for……….Years..…… months Please print name and position ……………………………………………………………………………………. Date ………………………………….

Signature ……………………………………………………..............

If no stamp is available please enclose a signed sheet of company headed paper.

Company seal or stamp

To the Applicant. This form must be fully completed and accompany a fully completed Membership Application Card before you can be considered for membership.

REGISTERED OFFICE: Bridgwater & District Credit Union, Victoria Community Centre, Victoria Park Drive, Bridgwater, Somerset TA6 7AS Telephone: 01278 447100 Bridgwater & District is a trading name of Somerset Community Credit Union Registration No. 213560

01/5/2015 FORM A3