Member Registration Form
Please complete the form below. Fields marked * are required.
First  Name* Required.
Last Name* Required.
Address* Required


Home Phone Number* Required.
Work Phone Number
Email Address* Required.Invalid format.
(min 8 characters with at least 1 number and 1 upper-case letter.)
Required.Minimum number of characters not met.Exceeded maximum number of characters.The password doesn't meet the specified strength.
Confirm Password* A value is required.The values don't match.

Swansea Village Co-op Registration Code

Each member was sent a special registration code by internal delivery. Please enter the code in the space below. Remember that it is case-sensitive.

If you have misplaced or forgotten the code, .

Registration Code* Required.

*Please enter the following security code: