Name of Organisation:

In applying for membership of the Clearing House Service, on behalf of the above organisation, you agree to abide by the CHS Terms and Conditions of membership.

Please enclose a copy of any one of the following items: Our most recent set of audited accounts
Our Certificate of Incorporation
Our Company Registration

We are sponsored by the following existing members of the CHS:(You do not need to be sponsored but it assists or validation process)

I certify that the details entered on this form are correct.
Tick this box to agree

Full Name:Title:


Account Opening Details

Address:
City:
Postcode/zip:
Country:
Name of Contact:
Title of Contact:
Telephone Number:
Fax Number:
Email Address:
Currency of CHS Account:
Name of your Bank:
Address of your Bank:
City:
Postcode/zip:
Country:
Branch No. / Branch ID:
Swift Address / IBAN No:
Bank Account Number:
Bank Account Name:

Please note that Swift Address, Branch No. / Branch ID, or IBAN number MUST be included.