Full Legal Name:
Date of Birth (MM/DD/YYYY):
Phone Number:
Email Address:
Street:
City:
State:
ZIP:
Preferred Contact Method:
PhoneEmailText Message
Select one:
Individual MemberFamily / Household MemberSmall Business MemberGig Worker / ContractorOther
If Other:
1. Why do you want to join The Members Branch Cooperative?
2. How do you plan to participate in cooperative programs? (Check all that apply)
Financial education programsReferrals and community outreachBusiness support activitiesMember surveys / advisory inputCooperative events and programsOther
3. Estimated level of engagement:
LowModerateHigh
(This helps determine participation tiering and eligibility.)
These questions protect YOU legally and ensure compliant membership.
1. Do you understand that The Members Branch Cooperative does NOT offer ownership, voting rights, or equity?
YesNo
2. Do you understand that distributions are NOT guaranteed and depend on performance, participation, and compliance?
3. Do you understand this is NOT an investment and NOT a security?
4. Are you willing to comply with the cooperative's rules, policies, and participation requirements?
(This section helps classify members and determine which programs they qualify for.)
Employment Status:
Employed full-timeEmployed part-timeSelf-employedBusiness ownerGig workerUnemployedRetired
Household Income Range (Optional):
Under $20,000$20,000 – $40,000$40,000 – $75,000$75,000 – $150,000$150,000+
Primary Financial Goals (Check all):
Earn supplemental quarterly incomeBuild financial stabilityReduce debtImprove cash flowSupport small business growthEducation + financial literacyCommunity involvement
Members must check all boxes to be accepted.
I acknowledge this is NOT an investment, security, or equity ownership program.I understand earnings and distributions are NOT guaranteed under any circumstances.I agree to follow all cooperative rules, policies, and participation requirements.I understand all distributions depend on performance, participation metrics, and cooperative financial outcomes.I certify that all information provided in this application is true and accurate.I authorize the cooperative to contact me regarding membership updates and participation opportunities.I agree to the Privacy Policy and Terms of Use.
Signature:
Date:
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