OWNER APPLICATION — FREE RANGE FOOD CO-OP

Free Range Food Co-op

Owner Application Form

OWNER EQUITY AGREEMENT

I agree to purchase one (1) share of Class A voting stock at $25.00, and three (3) shares of Class B equity stock at $25.00 each for a total of $100.00.

I understand that this application is subject to acceptance by the Board of Directors of the Co-op and that my ownership is subject to the Bylaws and ownership provisions.

A copy of the Free Range Food Co-op bylaws can be found here.

Name

First Name

Last Name

Additional Adults in Household, First & Last Names (list up to two)

Street Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Mailing Address (if different)

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Contact Phone Number

(###)

###

####

Email

Email is our main way of contacting owners with important co-op updates and information. Do you agree to receive newsletter & update emails from FRFC? (We never share your email with any other parties)

Yes, please keep me in the loop via email!

No thank you.

PAYMENT DETAILS

As with any investment, your ownership share is subject to risk. If the Co-op is unsuccessful, the Board of Directors will determine the distribution of remaining assets. In this unlikely event, every effort will be made to refund the paid portion of your owner equity share. Upon choosing a payment option, you will be directed to Square to complete your transaction. An administrative fee of $4.12 will be added to each transaction when paying by credit or debit card.

How did you learn about FRFC?

Were you referred by someone?

First Name

Last Name

Other FRFC owners love to see our numbers grow! Can we announce you as a new owner in our newsletter, on our website, or social media?

Yes; share that I have joined the co-op!

No, thank you; do not share my new ownership on social media.

Can we contact you about volunteer opportunities with FRFC?

Yes, please contact me about volunteering!

No thank you, I'm not interested in volunteering at this time.

Are you a farmer or producer?

Yes, I am a farmer or producer.

No, I am not a farmer or producer.

If yes, what do you grow or produce, and are you interested in selling your food/products in the co-op?

Please tell us what a food co-op in your community means to you. We may use this in announcing you as an owner on social media or in the newsletter. (optional)

Any questions or comments?