Green Top Grocery

OWNER INFORMATION

First Name*

Last Name*

Phone Number*

Please enter a valid phone number.

Email*

example@example.com

Address*

Street Address

Street Address Line 2

CityState

Zip Code

Additional Household Members? Fill in their names below

OWNERSHIP SHARES

Shares in Green Top Grocery Cooperative are $100 each. The minimum purchase is 2 shares. You may purchase up to 5.

Number of Shares to Purchase*

Total Purchase Price

Note: Purchasing additional shares does not increase your benefits or give you additional votes, but it WILL contribute to the financial sustainability of the co-op.

Subscription Agreement

For the purpose of facilitating access to consumer goods by providing
necessary capital funds for operating a retail food store, and to acquire an ownership interest in the Cooperative, I hereby subscribe to purchase {numberOf} shares (not less than two nor more than five) at a price of one hundred dollars ($100.00) per share for a total purchase price of {totalPurchase}.

The ownership interest hereby subscribed for is intended to confer the right to purchase consumer goods at owner prices and to participate in the governance of the Cooperative in accordance with its bylaws. The shares to be acquired hereby will entitle the holder to no dividends or other monetary return on capital, will be nontransferable except to the Cooperative, will be redeemable only in limited circumstances in accordance with the bylaws of the Cooperative, and will be subject to other terms and conditions in the bylaws of the Cooperative.

The capital funds remitted hereby are intended to be used for initial capital, start-up expenditures, future improvements, and other capital needs of the Cooperative. All such capital funds are subject to the risks inherent in any enterprise of this character and may result in the loss of part or all of such funds. Persons who cannot afford to incur such losses should not subscribe to purchase shares.

Signature*

Type your full name into this box to sign this document. By typing your name into this box, you agree that this typed constitutes your digital signature, is legally binding, and will be treated the same as a handwritten signature.

PAYMENT OPTIONS

Please choose among the following options. There are NO ANNUAL FEES as a Green Top Owner. Contact us if none of these options work for you. We want everyone to feel welcome at Green Top Grocery.

Full Payment: You will pay your full purchase price today.

Installment Option: Down payment of $20, plus monthly payments of $20 each until your total purchase price is paid in full. Your ownership will become active as soon as you make your first payment and will remain active as long as future payments are made when due.

Payment Option*

Full PaymentInstallment Option

Amount Due Today

Online Payment: Amount Due Today

USDGreen Top Grocery Cooperative Ownership Shares

Number of Future Payments

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