Hub City Cycles Co-op Membership Form

Member #

Name*

First NameLast Name

Address*

Street Address

CityState

Zip CodeCountry

Phone Number*

Area CodePhone Number

Email*

example@example.com

Member Class
There are 3 classes of membership, User, Support, Worker.
User members are eligible individuals or organizations in the community that make use of the services provided by the Association.

Worker members are individuals employed to work for the Association.

Support members are individuals or eligible organizations that have an interest in the achievement of the Association’s objectives but do not intend to use the services provided by the Association.

Member Class*

UserSupportWorker (do not choose this option unless you are an employee)

With the minimum purchase of one share, which costs $5 (refundable when you decide to leave the co-op), you can become a lifetime member.

# of shares you would like to buy*

Value of shares

Newsletter

I am Interested in receiving occasional email updates about events, classes and meetings. You can unsubscribe with one click at any time.

Volunteering

I am Interested in volunteering with Hub City Cycles in some capacity.

By signing below I agree to abide by the by the Hub City Cycle Community Cooperative Rules and Memorandum, the Cooperative Association Act of BC, and the Policies of the Association.

Signature*

Value of shares $*

CADDescription

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Please verify that you are human*