I hereby apply for a Children's Celebration Bond (Single Premium Version) on behalf of each of the above named child(ren).

I confirm that I have read the Bond’s Key Features Document.

I declare that, after having made all necessary enquiries with the child(ren)’s parent / guardian (as appropriate) the child(ren) is/are in good health and free from any adverse mental or physical condition.

I understand that this 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 until the child(ren) reach age 16.

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.

Please print off the completed Form, sign and date it, and post it (along with your cheque) to :

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

Compass Friendly Society Limited is authorised and regulated by the Financial Services Authority

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Release date 13/11/03