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2006 Nebraska Food Coop Member Registration

Thank you for your interest in becoming a member of Nebraska Food Coop, Inc. (NFC). Nebraska Food Coop customers and producers are interested in local foods and products produced with sustainable practices that demonstrate good stewardship of the environment. To become a member, please read the NFC Standards, and then complete the following information and click submit.
SECTION 1: GENERAL INFORMATION
First Name: Last Name:
First Name 2: Last Name 2:
Business Name:
Address: City:
State: Zip:
County: Phone:
E-mail:
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 download and read the available Member Information Statement before investing.)
Voting Member:
$100 (one share of common stock) plus a $20 annual membership fee (waived the first year)
Non-voting Member:
$40 (annual non-member fee)
How You Heard: If other, please specify:
YES! I�m interested in volunteering to help in the Nebraska Food Cooperative.
I acknowledge that I have read and understand the Nebraska Food Cooperative, Inc. Member Information Statement.

**Please mail your voting or non-voting membership fees check to:
Nebraska Food Cooperative, P.O. Box 94691, Lincoln, NE 68509-4691
Nebraska Food Cooperative, P.O. Box 94691, Lincoln, NE 68509-4691
Telephone: (800) 993-2379 �� E-mail: info at nebraskafood.org