TO BE ELIGIBLE FOR MEMBERSHIP, A RETAILER MUST (please check the following)

Be primarily engaged in the independent retailing of nutritional products from a self-contained store(s) where a minimum of 75% of the gross sales consists of items sold in health food stores such as nutritional food, food supplements and related items.

Have established business hours and storefront.

Business Name:

Owner's Name(s):

Voting Member's Name:

Address:

City: State: Zip:

Business Phone: Fax:

Email:
Website:

I am interested in serving on a NNFA-West Committee or Task Force
Please send information on the next Lobby Day

I will pay by: Check Credit Card

Card Number: Exp. Authorized Signature: Name on Card: Billing Address:         I Authorize NNFA-West to charge my: ____MasterCard ____Visa ____American Express