Main Market - Student Membership

Annual Student Shopper Information

* Indicates a required field

Buying a Main Market Co-op Student Shopper as a gift?
Please fill out the fields of the on-line form with your information – these are used to verify the credit card purchase. Then, duplicate the contact information for the gift recipient (new member) in the “comments” section at the bottom of the form, and we will generate a new member welcome note to them on your behalf!

First Name *

Middle Initial

Last Name *

School Name *

Student ID Number *

Current Address

Current Address 2

City *

State *

Zip (5 digit ZIP codes only) *

Country *

Phone *

Alternate Phone

Email *

I understand the student shopper is not a full member-owner of Main Market Co-op. My annual fee earns me most of the discount benefits of a membership, but without a full investment of ownership, I recognize I am not eligible for year-end dividend payments. However, I agree to the other terms and expectations as described in the Main Market Co-op Member-Owner Agreement. *

Comments / Special Instructions

Payment Information

Membership type *

Student - $30

Name on Card *

Credit Card Type *

Card Number *

3 Digit Code (CVV) *

Expiration Date (MM/YY) *

I would like to recieve frequent updates about Main Market Co-op

Yes No

Security Note: For your safety we use advanced secure server technology to encrypt your credit card information and protect it from unauthorized use. This is the safest way to transmit credit card information over the internet.

Personal information provided to Main Market Co-op will not be sold to third parties.

Prefer to pay by check

Please download printer friendly form and mail to:
Main Market Co-op, Attn: J. Hall, 44 West Main, Spokane, WA 99201

main market - 44 West Main - Spokane - WA - 99201
Phone: 509.458.COOP (2667)
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