The Village Co-op Market of Williamsville Member-Owner Application
Thank you for your interest in becoming a member-owner of The Village Co-op Market of Williamsville! Please complete the short form below.

It is the member-owner's responsibility to provide The Village Co-op Market of Williamsville with a current mailing address should your information change in the future. 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 your member-owner equity share.

Primary First Name *
Your answer
Primary Last Name *
Your answer
Household Name #2
Your answer
Household Name #3
Your answer
Street Address *
Your answer
City *
Your answer
State *
Your answer
Zip *
Your answer
Home Phone
Your answer
Cell Phone
Your answer
Work Phone
Your answer
Email *
Your answer
I give permission for The Village Co-op Market of Williamsville to display my name on their website or any promotional material. *
Please read The Village Co-op Market of Williamsville's by-laws here: http://villagecoopmarket.com/wp-content/uploads/2017/11/By-Laws-FINAL-10-2017.pdf
I have read the by-laws of The Village Co-op Market of Williamsville. *
Member-Owner Terms and Conditions
1) I am applying for a one-time purchase to be a member-owner in The Village Co-op Market of Williamsville under the conditions and policies state in the Articles of Incorporation and bylaws of The Village Co-op Market of Williamsville. Those documents may change from time to time by action of the member-owners or the Board of Directors.

2) I understand that a member-owner share must be in the name of one individual only. The legal member-owner of record will receive all official co-op mailings, is the official voting member-owner in all co-op elections, and receives any and all monies potentially disbursed, including patronage dividends and a refund of equity.

3) I understand that other persons living in my household may use my membership card to shop at The Village Co-op Market of Williamsville, but this does not confer member-ownership upon them.

4) I certify that I am at least 18 years of age.

5) I understand my member-ownership is not transferable.

6) I understand that I may resign this member-ownership after one year of profitability is achieved with Board approval.

7) I understand that this application for member-ownership is subject to the approval of the Board of Directors.

8) I understand that full rights of member-ownership (voting rights and eligibility for patronage dividend) are granted upon full payment.

Electronic Signature of Primary Member *
Please type first and last name
Your answer
I understand that typing my name above constitutes a legal signature confirming that I acknowledge and agree to the above Terms and Conditions. *
Payment
Your $150 investment can be made by credit card. Please follow the prompt upon submission to complete your transaction.
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