I hereby apply for a Children's Celebration Bond and membership of the Society on behalf of each of the above named child(ren).  I confirm that I have read a description of the Bond’s key features.

I declare that, after having made all necessary enquiries with the child(ren)’s parent / guardian (as appropriate) :-

a) the child(ren) is/are in good health and free from any adverse mental or physical condition, and

b) the total amount of premiums payable on behalf of the child(ren) for tax-exempt friendly society policies (including premiums payable under this Application) do not exceed £25 per month or £270 per annum.

I understand that the above Application and Declaration will be treated as having been made by the child(ren) and shall form the basis of the contract between the child(ren) and the Society.

I apply to the Society in my own name to become a Donor Member of the Society.

Donor’s signature ................................................................. Date ........................................................

If any part of this Application or Declaration does not apply in any respect, you should sign it and give any relevant information on a separate sheet of paper.

Warning - non-disclosure of a material fact (that is, one which an insurer would regard as likely to influence the assessment and acceptance of this Application) may affect the benefits payable. If you are in any doubt as to whether a fact is material you should disclose it.

Compass Friendly Society Limited, Old Bank House, 59 High Street, Odiham RG29 1LF

Authorised and Regulated by the Financial Services Authority

Please print off the completed Form before proceeding to the Standing Order Form    NEXT a

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Release date 09/11/04