Sample Page - SunCoast Market Co-op

Are you joining as a Household or Business?

Business Name (if applicable)

Owner Information

First Name*

Last Name*

Address

Address Line 1

Address Line 2

City

State or Region

Country

Zip

Phone Number*

Email*

Payment Information

Your ownership cost is $200. If you pay in full with a credit/debit card or PayPal today, we ask that you cover our service fee. Our installment plan is $10.85 a month as it includes a mandatory service fee. There will be 20 automatic payments total. There are no refunds.

Payment Type Choice

If you are paying by credit/debit or PayPal, select your option (leave blank for installment plans or gifts):

Full Payment (cover our processing fee) ( $207 )

Full Payment (without processing fee--cash or checks) ( $200 )

Full Ownership Assistance Program Payment (must have applied and been accepted) ( $100 )

You may choose to purchase additional shares to support the store financially. You will not receive additional votes or dividends/returns. Max 8 additional shares allowed. No payment plan for extra share purchases.

If you were gifted this ownership, please state who gave it to you:

Owner Agreements

Please check the boxes below:

I acknowledge receipt of a copy of the Cooperative’s Ownership Disclosure: (https://tinyurl.com/y4wwtw6e). I agree to receive ballot materials and official correspondence by email.

Ownership Terms

I hereby apply for ownership status in the SunCoast Co-Op Market. I understand that additional persons (listed above) in my household may use my Co-Op account and do not have voting rights. I certify I am 18 years of age or older.

By typing your name below you are submitting an electronic signature indicating your agreement to become a SunCoast Co-op Market owner. If you would like to submit a written, signed copy, please email us for a printable application.

Other Helpful Information

All owners can receive a free yard sign to help promote the store. Would you like a yard sign?

YesNoI would like a sign for my business instead

Can we announce that you are an owner in our materials and/or website? This will also be one part of our recognition campaigns, saying no means your name will not appear in public owner lists.

YesNo

We want to make it easy for owners to stay up to date. If you would like to receive occasional text message updates from SunCoast, please mark yes below. By marking yes, you consent to receive automated phone calls or text messages from SunCoast. Message and data rates may apply. You may revoke your consent at any time.

YesNo

Referral Program: If you heard about us from another owner, please share their name so they can earn a referral gift.

Would you like to volunteer?

YesNoPossibly

I authorize the following individuals from my household/organization to shop on my owner card: (must be in your household and authorized individuals do not have voting rights)

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Stripe= Full Payment with Credit or Debit Cards. Offline= Cash/Check/Installment Plan/Gifts--you will be directed to a detailed payment information page after you submit your application.

Owner Information

Payment Information

Owner Agreements

Other Helpful Information

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Owner Agreements

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