Ownership matters. When you become an owner you secure grocery access for you and your neighbors into the future. In addition to a grocery store that is responsive to your needs, you get selected discounts and rebates in profitable years, and you can even participate in the governance of the store. SIGN UP ON PAPER OWNERSHIP FOR LOW INCOME FAMILIES SIGN UP IN PERSON Become an Owner Number of shares $ 100.00 Enter the number of shares you're buying Processing fee - select - Paying online - $ 3.50 Paying by check or m/o - $ 0.00 Are you paying online? Total Amount New owner profile Prefix Mrs. Ms. Mr. Dr. Rev. First Name * Last Name * Email (Main) * Birth Date Neighborhood * What's the name of the neighborhood where you live? Street Address (Primary) * Supplemental Address 1 (Primary) City (Primary) * State (Primary) * - select - Alabama Alaska American Samoa Arizona Arkansas Armed Forces Americas Armed Forces Europe Armed Forces Pacific California Colorado Connecticut Delaware District of Columbia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northern Mariana Islands Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas United States Minor Outlying Islands Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming Postal Code (Primary) * Phone-Mobile (Primary) Phone-Landline (Other) No Bulk Emails (User Opt Out) Payment Options Payment Method Authorize.net I will send payment by check Credit Card Information Card Type - select - Visa MasterCard Discover Card Number * Security Code * Expiration Date * -month- Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec -year- 2018 2019 2020 2021 2022 2023 2024 2025 2026 2027 2028 My billing address is the same as above Billing Name and Address Billing First Name * Billing Middle Name Billing Last Name * Street Address * City * Country * - select - United States State/Province * - none - Alabama Alaska American Samoa Arizona Arkansas Armed Forces Americas Armed Forces Europe Armed Forces Pacific California Colorado Connecticut Delaware District of Columbia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northern Mariana Islands Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas United States Minor Outlying Islands Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming Postal Code *