Member-owner Application

I hereby apply for ownership in Hillsboro Food Co-op. As an owner, I agree to abide by the Bylaws of Hillsboro Food Co-op.

First Name:
Last Name:
Address: Apt. #:
City: State: Zip Code:
Phone:
Email:
I do not have access to email. Please send information to me via postal service.
Please list all other adults (i.e., over 18) in your household:
(Optional) Which Co-op member-owner referred you to Hillsboro Food Co-op?
(Optional) What motivated you to join the Co-op today?
Payment Options:
Full Investment: $200.00Monthly Installments: $20 each month for 10 months + $10 processing fee due with first paymentQuarterly Installments: $20 each calendar quarter for 2.5 years + $10 processing fee due with first payment

Please select your payment amount for today. If you want 100% of your share to go to the Co-op, you may choose to cover the PayPal fees.

It is the member-owner's responsibility to provide Hillsboro Food Co-op with a current mailing address should the above information change.

As with any investment, your ownership share is subject to risk. If the Co-op is unsuccessful, the Board of Directors will determine distribution of remaining assets. Every effort will be made to refund the paid portion of your member-owner equity share.

Please do not include my name on the Hillsboro Food Co-op website or any promotional materials.