ABU DHABII CO-OPERATIIVE LOAN FUND ABU DHAB CO-OPERAT VE LOAN FUND Al Ghaith Tower, Hamdan Street, Abu Dhabi, United Arab Emirates Email: email@example.com MEMBERSHIP APPLICATION FORM All prospective members of ADCLF are required to complete this registration form and return via the web site www.adco-oploanfund.com or by email to firstname.lastname@example.org or by post to P.O.Box: 545573 - Abu Dhabi, United Arab Emirates. All details will be kept in a secure database with access restricted to the executives only. SECTION 1: MEMBER CONTACT INFORMATION TITLE Mr Mrs Miss Ms Dr Other, specify: FULL NAME ADDRESS MAIN TELEPHONE WORK TELEPHONE P.O.BOX (if different) ZIP CODE HOME TELEPHONE TOWN/CITY MOBILE PHONE COUNTRY PRIMARY EMAIL NATIONALITY SECONDARY EMAIL SECTION 2: YOUR EMPLOYMENT DETAILS (Please tick the appropriate box) YOU TRADE A SOLE TRADER YOU TRADE AS A TRUST JOB TITLE YOU TRADE AS A PARTNERSHIP YOU TRADE AS A COMPANY OCCUPATION EMPLOYER’S NAME OR BUSINESS NAME IF SELF EMPLOYED? IF SELF EMPLOYED, WHAT IS THE NATURE OF YOUR BUSINESS? SECTION 3: MEMBERSHIP CATEGORIES AND PAYMENT DETAILS JOINING MEMBERSHIP Please MEMBER TYPE DESCRIPTION FEE DUES (Annual) Tick Gold Corporate Membership ($10.000) – includes a copy of the ADCLF Membership list, acknowledgement on the ADCLF web page, attendance at the Annual Meeting of the Board of ADCLF as Corporate Advisor, opportunity to discuss product concerns/ideas with Investors, plaque recognition at annual GOLD meeting, your corporate logo displayed on educational US$10,000 US$6,000 advertisements. Specifically, at the Promoting Continence Coast to Coast conference, Gold Corporate Members will be specially acknowledged in the conference program, invited to introduce one of the conference speakers and to have a slide of their company logo displayed during this introduction. • Silver Corporate Membership ($7.000) – includes a copy of the ADCLF Membership list, acknowledgement on the ADCLF web page, plaque recognition at annual meeting, attendance at Annual Meeting of the Board of ADCLF as a Corporate Advisor. SILVER Specifically, at the Promoting Continence Coast to Coast US$7,000 US$4,000 conference, Silver Corporate Members will be specifically acknowledged in the conference program and be featured at one of the coffee or meal breaks scheduled throughout the conference. • Bronze Corporate Members ($3,000) – includes a copy of the ADCLF Membership list, acknowledgement on the ADCLF web BRONZE page. Specifically, at the Promoting Continence Coast to Coast US$3,000 US$1,000 conference, Bronze Corporate Members will be specifically acknowledged in the conference program. SECTION 4: MEMBERSHIP SPONSOR Two existing Members must sponsor an applicant before he/she is accepted. Please have the sponsors sign the form and fill in his/her membership number. Name: Name: Position: Position: Company: Company: Address: Address: Telephone No.: Telephone No.: Nature of Relationship: Nature of Relationship: Signature : Signature : SECTION 5: MEMBERSHIP TERMS AND CONDITIONS 1). A pre-paid membership card is valid for 24months from the date of issue and any membership fee paid is not refundable 2). Membership card is not transferable. The member must not allow anyone else to use his/her card or membership for any purpose. Card is used by any person other than the authorised member will result in that member's membership being cancelled and the member being banned. No refund of the registration fee or subscriptions will be made 3). In the event that a member's membership card is lost or become unusable through damage, the member must inform ADCLF as promptly as possible. A replacement card will be issued to the member 4). The ADCLF reserves the right to reject any application or withdraw without refund any membership in the event of failure to comply with these Terms and Conditions of membership Rules 6). The membership scheme and members benefits may be varied from time to time and may vary during special events and functions without prior notice 7). If deemed necessary by the ADCLF the applicant shall obtain at his/her own expense written confirmation from his/her own district attorney that he/she is of good character before being accepted Reinstating Membership In the event of a membership subscription lapsing for any period or being cancelled, an administration fee of $700 will be charged to reinstate membership Suspension of Membership Suspension of membership will only be considered if the member cannot participate for Financial or Medical reasons. This will have to be supported in writing by the member's sponsors and will only apply from the date receipt of the letter If a member wishes to have his/her membership frozen he/she will have to apply in writing to ADCLF giving at least 1 month notice of this. Membership can be frozen for a minimum of 3months and a maximum of 6 months Membership Benefit The membership card will entitle you to be our guest at activities that we sponsor General Meeting, Conference and be shareholder with voting rights as well as participating businesses Members would like to contact you from time to time with various products offers and special promotions. This may happen via mail, telephone or electronic communications including email or short message service (SMS). If you wish to receive this information you may tell us sending email to email@example.com SECTION 6: Membership Requirements Attach a photocopy of any of the following valid I.D.’s (with photo) Passport - Voter’s I.D- Driver’s Licence The Co-operative Loan Fund The Co-operative Loan Fund aims to strengthen the size and scope of the co-operative sector through the provision of ethical, accessible loan finance. It exclusively lends to co-ops, and is entirely funded and run by co-ops, so unlike many conventional lenders it truly understands and actively supports democratically owned and controlled enterprises. It also reinvests its surpluses to continue its support. Loan applications are welcome from new and existing co-operatives that need $10,000 - $500,000.000 of loan finance to • Set up as a new co-operative • Expand their size and scope • Assist an employee buyout or company succession • Purchase a property or business • Purchase capital equipment or create working capital The Co-operative Loan Fund is able to make loans with initially low repayments of capital and interest. Lending by the Loan Fund will be at or near market terms. The Co-operative Loan Fund is willing to take secondary security behind other investors and is also able to make unsecured loans. We do not take personal guarantees on loans. Repayment terms There is no set lending term, as far as is possible loans will be tailored to the business and the capacity to make repayments. The maximum term is usually 10 years. Borrower criteria Loans are only available to co-operatives. Loans are only made to economically viable enterprises. MEMBER’S AGREEMENT AND RELEASE: Consistent with my desire to take personal responsibility for my conduct, individually and as a member of an ADCLF, I agree to abide by the principles contained in ADCLF Promise” and the governing documents and policies of ADCLF. I will refrain from any form of discrimination, harassment, derogatory, illegal, or unethical conduct, and I understand that if I engage in such conduct, I may be responsible to reimburse ADCLF, or other individuals involved with ADCLF, for any damages, losses, or costs resulting from my conduct. Understanding that ADCLF programs are conducted by volunteers who cannot be effectively screened or supervised by ADCLF, I release and discharge ADCLF, governing bodies and representatives from any liability for the intentional or negligent acts or omissions of any member or Officer of ADCLF, or any Officer of ADCLF . Joining and membership fees payment only by direct wire transfer, please contact us via email at firstname.lastname@example.org for the Account Number. By signing here you acknowledge that you have read and understood the privacy consent and declaration overleaf and declare that the details contained in this application are true and correct SIGNED (or write name here) DATE The information provided above will also be used to keep you informed about ADCLF events in future. FOR ADCLF USE ONLY: Date TT Payment Receipt Entered Received wire confirmed issued into DB Note: We thank you for your application and will return to you your membership card and receipt and if you have chosen to use our online facilities we will email you as soon as your membership card is posted.
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