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Share Investment Application Form

* denotes a mandatory field

Pledge Amount (£)*

Minimum £100, Maximum £100,000

Community *

Pledge Type *

Shareholder Status

Existing Shareholder? *

Contact Details

Forename *

Surname *

Email Address *

Phone Number *

Full Address *

Postcode *

National Insurance No. *

National Insurance Number required for proof of identity

Age Bracket

Appoint a Nominee

This section should only be completed if you are appointing a person you wish your shares to be transferred to on your death. We will respect those wishes (in so far as the law and our rules permit).

When considering appointing a nominee, you may want to familiarise yourself with Rule 12 (What happens on death, bankruptcy or mental incapacity?) of the Rules of Broadband for the Rural North Limited document

Appoint a Nominee? *

Investment Offer

Broadband for the Rural North Limited (B4RN) currently offers a waived connection fee and three months free service to new customers (not yet connected to the B4RN network) purchasing at least £1,500 worth of share, subject to the terms and conditions in the Share Prospectus document

Please indicate below if you believe you are eligible and wish to take up this offer.

Take up Investment Offer? *

Accept Privacy Policy *

I confirm I have read and understand the Share Prospectus *

After you send your form to us, a personalised application document will be generated and emailed to you for you to sign electronically. Signing instructions will be included as an attachment to the email. Signing is straightforward, safe and secure. Once signed, your completed application form will be automatically submitted back to us.

Gavin And Belinda Second Nature Smallban

Stories from out in the field from our very happy customers

One residential customer in Over Kellet used to know whether it was worth firing up her computer by looking out of her front window to see what the weather was doing with her telephone line.