Application Form

Speciality Coffee Association of Europe

scae.com

Membership Application ADMINISTRATION OFFICE Speciality Coffee Association of Europe, Administration Office, Oak Lodge Farm, Leighams Road, Bicknacre, Chelmsford, Essex, CM3 4HF, UK T: +44 (0) 1245 426060 F: +44 (0) 1245 426080 E: membership@scae-mail.com W: www.scae.com BANK ACCOUNT SWIFT: BARCGB22 Speciality Association of Europe, Barclays Bank, Rayleigh, Leicestershire LE87 2BB {EURO A/c.No.: 43783000 {IBAN:GB41 BARC 20-70-93 43783000 - Euro (¤) Payments Only {Sterling A/c No.: 00292036 {IBAN:GB65 BARC 20-70-93 00292036 - GB Pound Sterling (£) Payments Only HOW TO PAY All payments payable to SCAE can be made by card or inter-bank transfer in € Euros or £ Sterling. Please include your name and invoice number as reference. Bank charges not included and must be added to bank transfers.

Please enter details clearly in CAPITAL LETTERS using black ink. First Name

Title

Family Name Company Name Street & No.

Postcode

City

Country

Please note that Barista and Coffee Lover (Consumer) do not receive plaques Today’s date: DAY

MONTH

YEAR

Tel

Fax

Mob Email Web (VAT @ 20% will added where applicable)

VAT/IVA No.

Twitter Name:

Please turn over. All boxes must be completed in full.

Payment Method (How do you wish to pay for your membership)? Inter-bank transfer: Credit/debit card: Online credit/debit card payment:

SEND YOUR COMPLETED FORM: BY FAX TO +44 (0)1245 426080, BY EMAIL TO membership@scae-mail.com, POST to Membership Team, Speciality Coffee Association of Europe, Oak Lodge Farm, Leighams Road, Bicknacre, Chelmsford, Essex, CM3 4HF, UK. ANNUAL MEMBERSHIP RATES FOR 2013 Membership Category (Please tick one only) Coffee Lover (consumer)

Rates