Close your Membership or Change to Senior Member

Membership: Close Membership or Change to Senior Member

After completing this form, our membership coordinator will reply via email to confirm receipt of your request and verify your refund amount (if any). Refund checks are mailed four to six weeks from date of closing.

Name*
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Email*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Date of birth
My member number is

If you don't know your member number, please email membership@communityfood.coop or visit the store so we can look it up for you.
Current Status*
- I am currently a member-owner and want to close my membership
- I am now a senior (age 62 or older) and want to keep my membership
I request a refund of my equity investment (select option)*
- I want to receive an equity refund
- I would like to donate my equity investment to the Farm Fund
Reason for closing membership
- Moving Away
- Becoming a Senior Member
- Dissatisfied with Member Benefits
- Dissatisfied with Staff or Store
- Dissatisfied with Store Policy
- Can't Afford
- Multiple Accounts
Other reason for closing membership
We'll miss you! Please tell us why you are leaving.
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Membership: Close Membership or Change to Senior Member

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