Club membership form template - DOC 11 - DOC by 6681D3


									                              ABU DHABII CO-OPERATIIVE LOAN FUND
                              ABU DHAB CO-OPERAT VE LOAN FUND
                       Al Ghaith Tower, Hamdan Street, Abu Dhabi, United Arab Emirates Email:

                               MEMBERSHIP APPLICATION FORM
All prospective members of ADCLF are required to complete this registration form and return via the web site or by
email to 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.


 TITLE                 Mr          Mrs           Miss           Ms           Dr           Other, specify:


 ADDRESS                                                                                 MAIN TELEPHONE
                                                                                         WORK TELEPHONE
                                                                                         (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



                                                                                                JOINING        MEMBERSHIP      Please
                                                                                                  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
                            • 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.
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 :


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

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.

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 for the Account

 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

 (or write name here)                                                                           DATE

The information provided above will also be used to keep you informed about ADCLF events in future.

  Date                           TT                            Payment                          Receipt                         Entered
 Received                        wire                         confirmed                          issued                         into DB

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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