Name *
Date *
If you don't use email or aren't comfortable giving it out, please enter your phone number instead.
Are you an owner of the Moscow Food Co-op? *
On the back of your co-op ownership card, you will see a 9-digit number staring with 400, please input the last six digits here. If you don't know your owner number, you may leave this field blank.
Please select which of the following benefits you or someone in your household receive or are eligible to receive.
1. FLOWER recipients must reapply on an annual basis to confirm continuing eligibility. 2. Moscow Food Co-op ownership payments need to be up to date to receive a FLOWER discount. If you are not already an owner, you are eligible for a $10 credit for your first year of ownership. If you are having difficulty keeping up with your ownership payments, please reach out to us at outreach@moscowfood.coop. It is important to us work with you to preserve your discount status. 3. Owners whose FLOWER discount expires will not be eligible for retroactive discounts on purchases made after expiration. 4. We ask that the FLOWER discount not be shared with family members not listed on the active membership, with the exception of dependent children under 18 years of age. 5. Because customer profiles are updated manually, it may take 24 to 48 hours from the time your ownership becomes active for the FLOWER discount to be applied. Your cashier can bypass this by manually applying your discount.

One last thing!

Thank you for filling out our online FLOWER application - once you have filled out and submitted this form, you will need to bring proof of your current benefits (or proof of eligibility) to the Co-op and show them to a staff member. The staff member will confirm with our Outreach Coordinator that they saw your eligibility.  

If you have any questions about the application, the application process, proof of benefits, or any other item pertaining to the FLOWER program, you can email Max (mnewland@moscowfood.coop) or call the Co-op and dial extension 222.