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Our Co-op
Wellness Hub
>
Classes, Courses & Community Clinics
Therapies & Practitioners
Rooms
News & Blogs
Community Noticeboard
Shop
Food Boxes
Gift Vouchers
Membership
Events
About
Our Future
Our People
Our Strategic Plan
Legal & Finance
Media
>
Print Media
Supporters
About Co-ops
>
Other Co-ops
Co-op Documents
Co-Op Links
Related Links
AppGDPRS
Contact
Community Membership Form
*
Indicates required field
Name
*
First
Last
Email
*
Phone Number
*
Please fill out your details below (we use this information to stock the most appropriate products and host events you are interested in).
Gender
*
Male
Female
Other
Prefer not to say
Please select your gender
Age Range
*
18 – 24
25 -34
35 – 44
45 – 54
55 – 64
65+
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Please select your age range
Dietary Interests
*
Let us know what you are interested in
Agreement
*
I will pay the €1 membership when I am in the shop
I will collect my membership fob when I am in the shop
GDPR Agreement
*
I consent to allowing The Urban Co-op store my submitted information so that they can email me the newsletter, membership information and meeting details, plus promotional material via email or text
I consent to allowing The Urban Co-op store my submitted information so that they can email me the newsletter, membership information and meeting details, plus promotional material via email or text
Submit