Authorised by the Prudential Regulation Authority and regulated by the Financial Conduct 
Authority and the Prudential Regulation Authority 
The easy, flexible way to save and watch your money grow 



NB : If the premium is paid at greater frequencies than annually, the rates quoted increase by 4% 
Are you already a member of this or any other friendly society?: 
If yes, please provide the name of the lodge/society and the amount of annual contribution/premium to those policies below: 


How did you hear about our Society/Products? 


The information that you provide on this form will be held by the Grand United Order of Oddfellows and used to set up and administer the policy for which you are applying and for other business purposes. By taking out this policy we will rely upon this as our standard client agreement and for your own benefit and protection, you should read the terms within the Financial Products Key Information Document and Financial Products Table that are available to be reviewed on this page before signing. If you do not understand any point, please ask for further information. I confirm that I have not been given any advice by the Grand United Order of Oddfellows in relation to the purchase of this plan. 


Failure to mention any material fact (this is a fact that an insurer would regard as likely to influence the assesment and acceptance of an application for a policy) may affect the amount payable upon death or maturity. If an applicant is in any doubt whether the fact is material or not, it should be disclosed anyway. 
Processing of your personal data is necessary for the performance of our contract for services with you. Generally, this is the lawful basis on which we intend to rely for the processing of your data. Our policy is to gather and process only that personal data which is necessary for us to conduct our services appropriately with you. 
Conditions and copies of the completed application forms are available on request.- but if required, please print your application BEFORE submission. 
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