Membership Application

(Fill out this form and submit it, along with your Initial Membership Fee)

I have submitted herewith through the FCA secure web site the sum of $100.00, as payment in full for my lifetime membership fee.

I understand that my Membership Fee is a Lifetime Membership for me and my spouse. I also understand that Freedom Cooperative Association reserves the right to approve of the goods and/or services to be offered for exchange. I understand that if my membership is not accepted,and we cannot make satisfatory arrangements, that all of my money will be returned to me.

I have read the terms and conditions of the Membership Agreement, of which this Membership Application is a part, and do hereby state that I do understand all of the terms and conditions and will abide by them.

I hereby pledge to make the goods and/or services, that I have listed below, available to other club members, as they may desire to exchange for them, in accordance with the terms and conditions set forth in the Membership Agreement. The total amount of my pledge establishes my personal "line of credit" limit.

I am e-mailing a recent photo of me so it can be used on my membership card. I am also e-mailing other photos -- all with the name of the person clearly indicated -- for every card that I want issued. The photos are all in "jpg" format. I know that the pictures will be retained by the club for future reference and use.

By submitting this Membership Application Form I have effectively signed and accepted the terms and conditions set forth in this form and in the Membership Agreement as of the day and date indicated in the e-mail that will be received by Freedom Cooperative Association.

Salutation:
Name:
Address:
City:
State: Zip Code:
Country:
Email Address:
Home Page URL:
Pledge to FCA:
Enter as many different Items as you would like to offer, and enter the Total Pledged Value for each item pledged. For instance: 100 hours of Legal Services at $80 per hour would have an amount of $8,000 		Item 1: Amount:
Item 2: Amount:
Item 3: Amount:
Item 4: Amount:
Item 5: Amount:
Total Pledged Amount: This Amount, along with your Lifetime Membership Fee will be credited to your account
as a Line of Credit in the form of Freedom Credits.
Comments:
Number of Cards:
Lifetime Membership Fee: $100.00

Click on the "Submit" button to e-mail the information in the form

There is an Lifetime Membership Fee of $100.00 that must be paid before Freedom Cooperative Association will proceed with any action.

The fee may be paid by sending a Cashier's check, or Money Order, to:

Freedom Cooperative Association
P. O. Box 845
Lehi, Utah 84043

or

You may pay on-line through Pay-Pal with your credit/debit card