Idaho's Bounty Food Co-op, Inc. - Member Resources: New Member Form

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Address 2:

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New Member Form

If you would like to become a producer member, please give us a call at (208) 721-8074 so we can discuss your potential for selling through the Co-op. Please DO NOT fill out the membership form until you have first contacted Idaho’s Bounty.

Thank you for your interest in becoming a member of Idaho's Bounty Food Co-op, Inc.. Idaho's Bounty Food Co-op, Inc. customers and producers are interested in 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.

If you are already a member, please sign in here. Otherwise fill out the form below to become a member.

Section 1: General Information

First Name:		Last Name:
First Name 2:		Last Name 2:

Invoice Name:
NOTE: Invoice Name can be edited. It will be used to route your order and should be easily tracable to you. It could be the common form of your name like "Alf Jones" instead of "Alfred Jones". If preferred, your Business Name may be used for the Invoice Name.
Business Name:
I am interested in becoming a producer member for Idaho's Bounty Food Co-op, Inc..

Section 2: Contact Information

Work Address:
Work Address 2:
City/State/Zip:

Home Phone:		Work Phone:
Mobile Phone:		FAX:
Toll Free:

Email Address:
Email Address 2:
Home Page:	http://

Section 3: Access Credentials

Username:	Enter the word	Human validation text
Password:
Confirm:

Section 4: Membership Type

Membership Type:
	Individual, family, or business $10.00 annual fee – Purchases for home or internal business use Wholesale buyers $10.00 annual fee – Resale purchases for restaurants, stores, bakeries, etc. All producers $60.00 annual fee – Required for selling through the co-op

Section 5: Additional Information

How you heard about Idaho's Bounty Food Co-op, Inc.:
Please give more detail:	What website, from whom, which publication/date, etc.?

YES! I‘m interested in volunteering to help Idaho's Bounty Food Co-op, Inc..

I acknowledge that I have read and understand the Idaho's Bounty Food Co-op, Inc. Subscription Agreement.