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.

printPrint this Form

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:

__________________________
Whole Life Natural Market

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

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

Email: info@wholelifemarket.com

JULY & AUGUST: Monday - Friday: 9-6, Saturday: 9-4, Sunday: 10-2

OTHER MONTHS: Monday - Thursday: 9-5, Friday 9-6, Saturday 9-3, Sunday Closed

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