Member-Owner Registration Form

Become a Member-Owner

When you complete this form, you will be directed to Clover to make your $200 equity payment and finish your membership signup.

Prefer to pay in person? Please stop by the store and we can help you complete your membership there.

Name *

First

Last

Additional Household Member

First

Last

Add the name of an additional household member to your membership.

Email *

Email

Confirm Email

Phone Number *

Mailing Address *

Address Line 1

Address Line 2

City

State

Zip Code

Preferred Contact Method *

Email
Phone
Mail

Opt into E-Receipts? *

Yes
No

When you shop at the store, you can receipt automatically via email.

Opt into Newsletter *

Yes
No

Sign up for our weekly newsletter, “The Beet Blast”.

I agree to the KCFC Member-Owner Terms and Conditions *

I agree to the KCFC Member-Owner Terms and Conditions *

I agree to become a Member-Owner of the Kitsap Community Food Co-op under these terms and conditions: A Full Share investment is $200.00. If the Board of Directors deems it prudent, a Member-Owner may retire their shares and request a full refund of all payments.

Member-Owner Rights, Privileges and Responsibilities

Patronage Dividends: Only Member-Owners who have paid their full share investment are entitled to receive Patronage Dividends.
Patronage Dividends are issued at the end of profitable fiscal years, as determined by the Board of Directors. Patronage Dividends are proportionate to a Member-Owner’s total purchases during the prior fiscal year. Patronage Dividends are issued as store credit, or in some cases, by check (upon Member-Owner request), according to Co-op Policy. Patronage Dividends are valid for use for one year after the date they are issued.

Governance Rights: Member-Owners who have paid in full; or Member-Owners who have paid an initial installment, and who are not delinquent in later installments; may participate in elections, run for the Board, and may attend Board Meetings which are open according to Co-op Policy.

Member-Owner Responsibilities: Member-Owners must keep the Co-op informed of their current address, and must stay current in any share installment payments (if applicable).

Termination and Inactive Status: Member-Owners who fail to make a timely monthly payments will, after a 30-day grace period, become Inactive. Inactive members may not participate in elections or run for the Board, attend Board Meetings, and are not entitled to a refund of Member-Ownership payments. Inactive Member-Owners may restore regular active status by paying delinquent amounts.

For a complete list of Member-Owner rights and responsibilities, you may refer to and download a copy of the Co-op bylaws at www.kitsapfood.coop/bylaws

into Member-Owner Number

Proceed to Payment ($200)

Share this: