Email Statements Signup

Email Statements Signup
Pembina West Co-op Member Number*
Name*

First NameLast Name
Company Name
Email*
example@example.com
I authorize Pembina West Co-op to send my account statements and related documents to the above noted email address.
Please note that your emailed statement will replace your printed statement. There is no option to receive the statement both emailed and printed.
Please also keep me up to date with occasional emails from Pembina West Co-op featuring news and special promotions relating to:

Pembina West Co-opFarmers, ranchers, and producersBuilding products & hardwareContractor's ChoiceFuelFoodPharmacyKids Club
Name(s) of Kids Club members*
I authorize Pembina West Co-op to send me emails relating to the topics selected above
Should be Empty: