Co-Op Membership Agreement

To become a member, please print and complete this form.

Bring your completed agreement to the store or fax it to us at 255-8866.

After the agreement is approved, we will provide you a Membership Number
that will enable you to place co-op orders in the store and online.

Please review our Co-op Ordering Information before completing this agreement.
Last Name:	__________________________	First Name:	__________________________
Address:	____________________________________________________
City:	__________________________	Maine Zip Code:	__________________________
Email:	____________________________________________________
Phone:	__________________________	Fax Machine:	__________________________
Would you like to receive the Whole Life Co-op Newsletter? YES____ NO____
By signing this paper I agree to follow all policies and procedures regarding the Whole Life Co-op. I also understand that this is a service provided by Whole Life Natural Market and Whole Life reserves the right to refuse an order due to failure to adhere to this agreement.
Signature:	__________________________	Date Signed:	__________________________

4 Colonial Way, Store 3, Machias, ME 04654 (Address formerly known as 80 Main Street)

Phone: 207-255-8855 ~ Fax: 207-255-8866

SUMMER HOURS: Monday - Saturday: 9-6, Sunday: 10-2

WINTER HOURS: Monday - Thursday: 9-5, Friday 9-6, Saturday 10-4, Sunday Closed