Idaho's Bounty - Member Registration Form -

2008 Idaho's Bounty Co-op Member Registration

Thank you for your interest in becoming a member of Idaho's Bounty Co-op, Inc., (IBC). Idaho's Bounty Co-op customers and producers support local foods and products produced with sustainable practices that preserve the cultural heritage, landscape, water, and air vital to a sustainable community. This form upon approval will register you to buy products within the Idaho's Bounty Co-op. Please read the Subscription Agreement and then fill out and submit the form below.

SECTION 1: GENERAL INFORMATION
First Name:	Last Name:
First Name 2:	Last Name 2:
Business Name:
Address:	Address 2:
City:	State:	Zip:
County:	Home Phone:
Cell phone:	Work Phone:
E-mail:
Select your Preferences here. You will be able to change these preferences from your member area later if necessary.
Delivery Type:	Delivery Location:
Preferred Method of Payment:	Check PayPal online
Please choose a username and password which you will use to log in to the member pages.
Username:	Password:
Please confirm your password:
SECTION 2: MEMBERSHIP FEES (Please read the available Subscription Agreement before investing.)
I/we hereby apply for consumer membership in Idaho's Bounty Co-op as a/an: Individual or Family $75 Business or other organization $100.00 You can pay by PayPal or check. The information will be on the following page.
How You Heard:	If other, please specify:
YES! I�m interested in volunteering to help in Idaho's Bounty.
I acknowledge that I have read and understand Idaho's Bounty's Subscription Agreement.
Please enter this code in the box:

**Please mail your voting or non-voting membership fees check to:
Idaho's Bounty Cooperative, P.O. Box 4617, Ketchum, ID 83340
info@idahosbounty.org (208) 721-8074

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