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Last Name 1:
First Name 2:
Last Name 2:
Home Address Line 1:
Home Address Line 2:
District of Columbia
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When you start your first order you will have the option to choose one of the following shopping access options:
Free trial - You may place one order for free. After that you may choose one of the options below.
Shopping pass for 1 order - A $6.00 fee will be added to each order you place. At the time you start an order you will be given the option to continue this level of access or upgrade to one of the choices shown below.
Shopping pass for 1 year - A $25.00 fee will be added to the first order and will be good for 12 months. After 12 months you will have the option to continue this level of access for another year or switch to one of the other choices.
Join the Oklahoma Food Coop for lifetime shopping - A one time $51.75 membership fee will be added to the first order.
I would like to redeem the following gift certificate:
How did you hear about the Coop?
Flyer or Booth
Friend or Family
If other, please specify:
I wish to declare a disability or other medical condition that contributes to my need for a home delivery at a discounted rate.
I wish to declare a lack of household automobile transportation that contributes to my need for a home delivery at a discounted rate.
I am interested in becoming a producer member, tell me more.
Please choose a username and password which you will use to log in to the member pages.
*Your password must be at least 6 characters long.*
Are you a real person? If so, enter the answer to the math question below.
(This helps us keep spam bots from submitting bogus applications)
What is the sum of nine plus three?
By submitting this application, I affirm that I have read the Oklahoma Food Cooperative's
Terms of Service
and fully understand and am willing to comply with them.
I agree to the Terms of Service of the Oklahoma Food Cooperative.
If you have any questions about this form please email
Oklahoma Food Cooperative
PO BOX 681, Oklahoma City, OK 73101