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MEMBERSHIP AUDIT

PLEASE COMPLETE ALL APPROPRIATE FIELDS TO UPDATE YOUR MEMBER PROFILE
FOR MORE THAN 5 STORE LOCATIONS, PLEASE DUPLICATE THIS FORM AND COMPLETE.
YOU MAY ALSO PROVIDE AN EXCEL SPREADSHEET OF STORE/LOCATION DETAILS.

Membership Audit

BUSINESS INFORMATION

CONTACT INFORMATION

Primary


Accounting

Marketing

1. Does your store(s) offer any of the following: (Check all that apply.)

STORE/LOCATION INFORMATION

Store/Location

Store/Location

Store/Location

Store/Location

Store/Location

Start Over

For questions or more information about the Membership Audit or your Company Online Dashboard, contact Molly Talley, OGA Director of Operations at 614-512-6424, or molly@ohiogrocers.org