Member Application - Mississippi Market Co-op

Thank you for your interest in becoming a member-owner at Mississippi Market Co-op. Please allow up to 5 days for your application to be processed. If you want to become a member-owner and shop immediately, please join in-person at one of our stores as we need time to process online applications.

To become a member-owner, fill out the below membership application and choose to pay a one-time stock investment of $90 or spread out the investment in a 2-year payment plan. Alternatively, you can learn more to see if you qualify for our affordable $12 LIME membership. **NOTE October 7 through October 21 (2024) we are giving away 100 FREE LIME Memberships during our Member Drive. In order to redeem a FREE Membership, you must apply for the LIME membership in person in one of our stores.

Membership Type(Required)

Mississippi Market Member-Owner

Mississippi Market LIME Member-Owner

Name (Primary account holder)(Required)

First Last

Would you like to add a household user?(Required)

Additional Household Member(Required)

First Last

Mailing Address(Required)

Street Address Address Line 2 City State ZIP Code

Email(Required)

Enter Email Confirm Email

Phone(Required)

Which store would you like to pick up your member-owner packet?(Required)

Did anyone refer you to join the co-op? If so, please let us know who:

Did a specific staff person refer you to join when you were in store? Let us know their name here

Would you like e-receipts?(Required)

Yes, please!

No, thanks.

Newsletter

Add me to e-newsletter mailing list

Signature(Required)

Date

Payment Options(Required)

$90 payment in full

$25 down installment *

* $25 down installment paid today, followed by three $25 payments, one every six months for 18 months, totaling $100 (total includes a non-refundable $10 admin fee)

Payment Options(Required)

$12 LIME down payment, with future payments applied from patronage dividend earnings until $90 is reached*

* No payment due at this time. LIME membership payment and verification will be finalized in-store. LIME membership requires photo ID with same name as enrollment proof for: SNAP, Section 8, WIC, supplemental security income, social security disability, refugee assistance, general assistance. Must renew each year.

Total

Billing Address(Required)

Street Address Address Line 2 City State ZIP Code

Credit Card(Required)

Card Details

Cardholder Name

Untitled

Name

This field is for validation purposes and should be left unchanged.