Created by potrace 1.15, written by Peter Selinger 2001-2017
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Created by potrace 1.15, written by Peter Selinger 2001-2017
Created by potrace 1.15, written by Peter Selinger 2001-2017
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C.A.N. Discount Application
Everyone is welcome to shop at the Co-op and deserves to have access to organic, healthy, and affordable foods. The Ashland Food Co-op’s CAN program strives to support economically challenged Co-op owners by offering a discount to eligible families and individuals in need.
C.A.N. participants will receive an everyday 5% discount throughout the store.
Enrollment is simple! Visit our website at
ashlandfood.coop/can
or stop by the Information Desk for an application.
Must be an Ashland Food Co-op Owner
Must provide current enrollment documentation for one of the programs listed below (dated within a year of today's date)
SNAP (Supplemental Nutrition Assistance Program; also known as EBT)
TANF (Temporary Assistance for Needy Families)
WIC (Women, Infants & Children)
Medicaid
SSI (Supplemental Security Income)
SSDI (Social Security Disability Income)
HUD (Housing and Urban Development)
HTBA (Home Tenant-Based Assistance)
Section 8 Assistance
Once your application has been reviewed and approved, the 5% C.A.N. discount will be associated with your ownership. The discount will be automatically applied at the registers during checkout.
Annual Enrollment is one year from the application date. Please provide an email address and you will be notified of your renewal deadline a month before it expires. Please re-enroll before the deadline to avoid interruption of your discount benefit.
Please allow 3-5 business days for processing.
* indicates required information for submission.
First name
Last name
Owner number
Address
Address
Address 2
City/Town
State/Province
- Select -
Alabama
Alaska
American Samoa
Arizona
Arkansas
Armed Forces (Canada, Europe, Africa, or Middle East
Armed Forces Americas
Armed Forces Pacific
California
Colorado
Connecticut
Delaware
District of Columbia
Federate States of Micronesia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Marshall Islands
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Palau
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
ZIP/Postal Code
Phone number
Email address
Email address
Confirm email
Proof of eligibility
*
Please click on the button below to upload current enrollment documentation from one of the following eligible programs:
SNAP
(Supplemental Nutrition Assistance Program; also known as EBT)
TANF
(Temporary Assistance for Needy Families)
WIC
(Women, Infants and Children)
Medicaid
SSI
(Supplemental Security Income)
SSDI
(Social Security Disability Income)
HUD
(Housing and Urban Development)
HTBA
(Home Tenant-Based Assistance)
Section 8 Assistance
One file only.
64 MB limit.
Allowed types: txt, rtf, pdf, doc, docx, odt, ppt, pptx, odp, xls, xlsx, ods, jpg, jpeg.
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