Membership Agreement Form

Fill out this form to begin your process of becoming a La Montanita Food Co-op Member.

"*" indicates required fields

Primary Member Information

First Name*

Last Name*

Middle Initial

Preferred Name (if applicable)

Pronouns

Mailing Address*

Street Address City State / Province / Region ZIP / Postal Code Country

Phone*

*Your phone number will be your membership ID

Email*

Select the communications you'd like to receive:

Member Notifications - highly recommended

The Scoop Newsletter

Sales & Promotions

E-Receipts (help us save paper)

Household Members

Primary members may add up to two (2) household members to their account. These additional individuals will have access to many of your member benefits. Please refer to the membership policies section for details.

Last Name

First Name

Middle Initial

Last Name

First Name

Middle Initial

Membership Policies

Through member participation, our co-op exists and members receive its benefits.
Membership is non-transferable.
The primary member owns the membership and is solely responsible for maintaining current contact information including mailing address, email, phone number, and household member(s) account access.
Primary member may cast one (1) vote in the annual election.
Primary member will receive annual notification regarding patronage dividend. After fiscal year finances are approved, co-op profits will be distributed or reinvested to benefit members as determined by the member-elected board.
Purchases made during any membership lapse will not be credited to your account. To ensure your purchases are linked to your membership:
- Enter your membership ID (primary member phone number) at the time of purchase.
- Or verify with your cashier.
Membership cannot be added to completed transactions.
Members must comply with all membership requirements.
Membership termination and reinstatement are subject to La Montanita policies and bylaws.

We encourage all members to review our Bylaws and Board Governance Policies available on our website at lamontanita.coop/board to better understand how we operate and to get involved.

Data Privacy Statement

We are committed to guarding our members’ privacy to the highest degree possible, consistent with legitimate business needs and legal requirements. Protecting the security and privacy of our members is of the utmost importance. Only staff authorized to enter and access member information may do so. Staff will not disclose data supplied by members to anyone at any time. Our full data privacy policy is at our information desk or online at: lamontanita.coop/privacy.

Signature*