NEIC Pledge Form

NEIC Membership Pledge
Full Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Neighborhood
Phone Number

Area CodePhone Number
E-mail
I prefer to receive NEIC communications by:
I pledge to purchase a membership share for $1,000.00 by the following date. (Installment options are available; please contact board@neic.coop for details.)
I would consider an additional investment or loan to NEIC to purchase a property.
I am willing to write a letter of support, or to publicly endorse the cooperative.
I am willing to share my expertise doing the following (check all that apply):
I think this is a great idea, and I want to see it happen! I think the time has come for this concept because:
Should be Empty:

NEIC Membership Pledge