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AFC Gift Membership
Thank you for choosing to give someone the gift of membership in the Androscoggin Food Co-op!
Your Name
*
First
Last
Your Phone
*
Your Email
*
Enter Email
Confirm Email
Your Address
*
Street Address
Address Line 2
City
State
State
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
ZIP Code
Recipient's Name
*
First
Last
Recipient's Address
*
Street Address
Address Line 2
City
State
State
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
ZIP Code
Recipient's email (we'll notify them this way)
*
Message to Recipient (optional)
We'll contact the person you designate above as the recipient of this gift membership to enroll them in the Co-op, and include any comment you make here:
I Understand that:
*
Patronage Refunds and voting privileges, as well as the ability to request changes to this gift account, will be tied to the Primary Member-Owner of the account (the Recipient) only.
Yes, I understand and agree.
I do not understand. Please contact me.
Payment Options
*
Pay Now in Full - $200
Help Your Co-op: cover the $6.10 processing fee. - $206.10
Pay by Mail in Full - $200
Total
$0.00
Home
About Us
What’s Next
Become a Member-Owner
Join Today!
Gift Memberships
Get Involved
Our Products
FAQ
Contact Us