NORTH STAR ELECTRIC MEMBER BENEFIT PROGRAM

PARTICIPATING BUSINESS AGREEMENT

Name of Business ________________________________________________

Mailing & Physical Address _________________________________________

City State Zip _____________

Phone Business Hours ___________________

Person representing Business: (Printed Name) _____________________________

Title: E-Mail Address: ______________________

Your Business is (circle one): Retail Restaurant Lodging Sports Other: ________

Brief description of Business: _______________________________________

____________________________________________________________

____________________________________________________________

I agree to be a participating Member Benefit Business and will give discounts to card carrying North Star Electric members. Terms of the agreement are to be effective from date of signature (below). North Star Electric is not liable for financial or contractual responsibilities of its members. This agreement can be terminated at either party’s discretion with a written 60 day notice. If the participating business changes ownership, contract will become null and void.

Discounts Offered to North Star Electric Co-op Member Cardholders: ________________________________________________________

________________________________________________________

________________________________________________________

Signature: ___________________________________Date _________________

Please Fax (218 278-4748) or return this form to: North Star Electric Co-op

PO Box 371 = Littlefork, MN 56653

After we receive your signed agreement, we will mail your participating member benefits package which includes window and cash register stickers to display in your business helping to identify you as a participating Co-op Connections business.

PLEASE MAKE A COPY OF THIS AGREEMENT FOR YOUR FILES