Online Member Application

Welcome to our Membership Application page. By completing this short application and making your first equity payment, you can become a member of the Co-op immediately, which will make you eligible for member discounts and rebates.

When you submit this application form (by clicking the "Submit Application" button below), you will be forwarded to an online credit card payment page so that you can make your first equity payment. When that process is complete, you will be returned to this site and you will be able to log in with your new username and password.

Please note that all fields marked with a red asterisk are required.

Equity Payment
Our current minimum annual member equity payment is $30.00. However, you are free to pay more if you like, up to our current full investment level of $400.00. Once you are fully invested, your household will not need to make any more equity payments.

Household & Billing Information
Please supply your current name and your household's current address. You will be set up as the Primary Member for this household. Please supply alternate billing information if necessary -- it must match what appears on your monthly credit card statement and you will not have another chance to modify it.

HouseholdBilling (supply only if different)
First Name*:
Last Name*:
Address*:
Address 2:
City*:
State*:
Zip*:
Phone*:
Email*:
Date of Birth*
(mm-dd-yyyy):
n/a

Additional Household Members (Adults and Children)
(Dates of birth required for all members, email requested for adults)

1. First:  Last:
Birthday:  Phone:
Email:
2. First:  Last:
Birthday:  Phone:
Email:
3. First:  Last:
Birthday:  Phone:
Email:
4. First:  Last:
Birthday:  Phone:
Email:

Beneficiary Information
In the event of the Primary Member's death, a household's equity will pass to the next adult in the household. If there are no other adults in the household, equity will pass to the designated beneficiary. While having a beneficiary is not required, it is recommended. If you choose, you may designate Weavers Way Community Programs, our non-profit arm, as your household's beneficiary, by specifying "WWCP" in the Name of Beneficiary field below.

Name of Beneficiary:
Relationship:
Address:
City:
State:
Zip:
Phone:

Payment
You can pay as little as $30 each year, or you can pay in larger installments. You can also pay the entire $400 now. Making your $400 payment all at once is much more valuable to the Co-op than paying $30 annually over the next 13 years. It provides valuable business capital that is invested in all aspects of our operations. If you make a $400 payment now, we'll even send you a $40 gift card as our way of saying thanks.

Please choose an amount of member equity to pay now.

Equity Amount: