Hensall Co-op Membership Information Update

Dear Member:

Thank you for updating your Member information.  

If you are not yet a member, the application is available here. Please complete the form online. You can print it after it is completed.

Fields marked with * are required.


PersonalBusiness

Customer information

Member number: *
Firstname: *
Middle Initial:
Surname: *
Date of Birth: *Month Day Year
Email Address: *
Telephone Numbers
Home Phone:
Cellphone: *No Cellphone
Mailing Address
Street:
City:
Province:
Postal:

Business information

Member number: *
Business Name: *
Firstname:
Surname:
Email Address: *
Telephone Numbers
Home Phone:
Cellphone: *No Cellphone
Mailing Address
Street:
City:
Province:
Postal:


HDC Logo Hensall District Co-operative Inc.
1 Davidson Drive, P.O. Box 219,
Hensall ON N0M 1X0
TF: 1-800-265-5190 | T: 519-262-3002 | F: 519-262-2317