Membership Application - Individuals


If you have any questions please call 1.800.265.5190, option 2.


Direct Deposit: Forward copy of a void cheque or a completed direct deposit form from your banking institution via fax 519-262-2317, mail to Hensall Co-op or deliver to a Hensall Co-op location, Attention: Membership.


Disclaimer: By completing this application you authorize and consent that Hensall District Co-Operative, Incorporated can release your information when required by the Co-Operative Corporations Act (section 120). 


If you prefer - we have a pdf form that can be completed and returned to us:


Individual Membership Application


The number you can be contacted at during regular business hours.
Please provide your date of birth in the following format
**If you would rather not provide your SIN and DOB via this online form, please complete the rest of the form and submit it, then call 519-262-3511 ext 262 with your details.

How will you be paying?

By selecting ‘Agree’ and submitting this form, you
- are signing this application electronically,
- agree your electronic signature is the legal equivalent of your manual signature and
- agree to the terms and conditions stated.