Membership Form Test1

West Colfax Food Co-op Membership Form
Membership Agreement

Applicant's Statement: I hereby apply for membership in West Colfax Food Cooperative (WCFC) and agree to abide by the articles of incorporation and bylaws of the association (http://westcolfaxfoodcoop.org/wp-content/uploads/2015/10/WCFCBylaws_FinalDraft.pdf), now and hereafter in effect, copies of which have been made available to me for inspection. I certify that I am a consumer interested in buying the products offered by WCFC; once open, I commit to patronizing the co-operative on a regular basis; I have tendered the purchase price of one share of common voting stock; and I have met such other qualifications for membership as have been explained to me.

On the annual anniversary of the date of my membership's acceptance by the cooperative (the effective date), my membership shall automatically renew for a subsequent one-year period; however, either party may terminate my membership by notifying the other party of this intention to do so in writing no later than 30 days after the effective date. It is mutually agreed that the failure of either party to this agreement to provide such notice shall constitute conclusive evidence of the parties' intention to renew this agreement for a subsequent one year period.

* Required
First Name *
Your answer
Last Name *
Your answer
Email *
Your answer
Address *
Your answer
City *
Your answer
Zip Code *
Your answer
What neighborhood do you live in?
Your answer
Phone number *
333-333-3333
Your answer
Are you interested in hearing about volunteer opportunities with the co-op?
Additional household members
Additional household members
You may add multiple adults residing at the same address to this account. Right now, you may add one additional adult at no extra cost. Later, additional adults may be added for a nominal processing fee.

It is assumed that the person filling out this form is the primary account holder. The primary account holder receives the patronage, equity, and right to vote which is correspondent to the member account, regardless of how many adults of the same household utilize the account. If the other adult(s) wants the full rights of membership, they should apply for membership separately.

Additional Household Adult - Full Name
First MI Last (Jane A. Smith)
Your answer
Member E-Signature
I certify that all of the forgoing information is correct. I understand that by submitting payment and submitting this form, I am applying for membership in WCFC. I understand that I will be contacted by WCFC regarding my membership status.
Member E-Signature *
Type your first and last name in brackets (e.g. "/Firstname Lastname/")
Your answer
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