Member-Owner Application Question Title * Owner Name (first & last name- this is the sole member-owner who can vote in co-op elections) Question Title * Up to two (2) additional adults in your household may use your member-owner number. Please list them here: 1. 2. Question Title * Contact Information Address * Address 2 City/Town * State/Province * ZIP/Postal Code * Phone Number * Question Title * Email Question Title * Co-op Mailing Lists Opt me out of promotional mailings (2-3 times annually) Opt me out of promotional emails (1 per week) Question Title * Are you a Double Up Food Bucks participant? Yes No Terms & Conditions• I am applying for lifetime membership in Lexington Cooperative Market under the conditions and policies stated in the Articles of Incorporation and Bylaws of Lexington Cooperative Market. Those documents may change from time to time by action of the membership or the Board of Directors. Bylaws can be found at www.lexington.coop. • I certify that I am at least 18 years of age• I understand that this application for membership is subject to the approval of the board of directors. • I understand that a member-owner share must be in the name of one individual only; my name is printed above. 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. • I acknowledge that I have received a copy of the bylaws of the Cooperative including Article 5.2 which provides information regarding IRS tax treatment of dividends. Question Title * E-SignatureI attest that the information provided by me on this application is true and accurate. I agree to the terms and conditions outlined on this application. I have read the terms and conditions Question Title * Today's Date This is the end of Step 1! After you click "Submit" please scroll down and make your one-time $80 co-op investment. Submit
