APPLICATION FORM
Application for Membership in Beranghi Co-operative Ltd
Co-operatives Act 1992 (NSW)
Last Name of Applicant: _____________________________________________________________
Other Names: ____________________________________________________________________
Occupation: _____________________________________________________________________
Full Postal Address: _______________________________________________________________
_______________________________________________________________
Address to which notices & newsletters are to be sent: ____________________________________
Phone & Email Contacts:___________________________________________________________
1. I apply to be admitted as a member of the above-mentioned Co-operative
and to be allocated one (1) share (“share”), and in respect
of this application I undertake to lodge: (please tick)
— The sum of $800 as a 10% deposit, in support of my request
for a share.
— The sum of $8,000 plus Annual Levy, being full payment of all
costs to join the cooperative in 2007.
2. When the application is approved and the share is allocated to me,
I agree to pay within one (1) month the remaining amount of $7,200 plus
the Annual Levy to complete the payment of all charges.
3. I acknowledge that the sum of $8000 is apportioned as follows:
(a) Share Capital = $6000
(b) Non-Refundable Joining Fee = $2000 (determined at AGMs but not to
exceed $10,000)
4. Current Annual Levy (determined at GMs) = $250 payable as cash in
advance OR payable as:
— $150 cash plus $100 worth of Board approved goods
— Pro-rata amounts payable from when you pay the $8000. e.g . Enter
in January: Levy = $125
5. I acknowledge that the Co-operative may introduce other charges (eg.
A Residents Levy) which would have to be approved by members at a GM
but will not exceed $50 week.
6. I agree to be bound by the rules of the Co-operative and any subsequent
alterations to the rules registered in accordance with the Co-operatives
Act 1992 and I also agree to be bound by the Beranghi by-laws which
I acknowledge are accessible via the Beranghi website.
Please follow the steps for buying a share and submit as required.
Signed: _________________________________(applicant)
Signed: _________________________________ (witness)
Name of witness: __________________________
Date: __________________________________
Please complete and send to: Beranghi Co-operative Ltd, Berrys Lane,
Crescent Head NSW 2440
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