sAY Yes TO sAvINGs.

costco members enjoy low warehouse prices on brand-name products, backed by our 100% satisfaction guarantee. household items electronics Groceries Apparel Optical Gas station Pharmacy and more receive a $20 Costco Cash Card when you join as a new executive Member.
AwAreness Code: 62000 CostCo CAsh CArd ACtivAtion: 335973

cOsTcO FOr BUsINess

run your business for less with all the products you need at our everyday low prices, backed by our 100% satisfaction guarantee. Plus, check out costco services designed to save your business money. electronics Office supplies Items for resale Break room supplies Gas station cleaning products receive a $20 Costco Cash Card when you join as a new executive Member.
AwAreness Code: 62000 CostCo CAsh CArd ACtivAtion: 335973

chOOse YOUr MeMBershIP LeveL

executive Membership: Features an annual 2% reward (up to $750) on qualified costco purchases. Terms and conditions apply.
see the membership counter for details.

Or receive a $10 Costco Cash Card when you join as a new Gold star Member.
AwAreness Code: 62000 CostCo CAsh CArd ACtivAtion: 321342

chOOse YOUr MeMBershIP LeveL

executive Membership: Features an annual 2% reward (up to $750) on qualified costco purchases. Terms and conditions apply. see the
membership counter for details.

Or receive a $10 Costco Cash Card when you join as a new Business Member.
AwAreness Code: 62000 CostCo CAsh CArd ACtivAtion: 321342

Gold star Membership: everything costco has to offer, without the 2% reward.

Offer is only valid through March 31, 2012, when you join in person with a Costco representative. Valid only for new members for their first year of membership. Limit one Costco Cash Card offer per household. Offer is nontransferable and may not be combined with any other offer or coupon. A Gold Star Membership is $55 a year. An Executive Membership is an additional $55 upgrade fee a year. Each membership includes a free Household Card. Costco accepts cash, checks, debit/ATM cards, EBT, Costco Cash Cards, Costco Credit Cards and American Express. Departments, products and services may vary by location.

Business Membership: everything costco has to offer, without the 2% reward.

Offer is only valid through March 31, 2012, when you join in person with a Costco representative. Valid only for new members for their first year of membership. Limit one Costco Cash Card offer per household. Offer is nontransferable and may not be combined with any other offer or coupon. A Business Membership is $55 a year. An Executive Membership is an additional $55 upgrade fee a year. Each membership includes a free Household Card. Costco accepts cash, checks, debit/ATM cards, EBT, Costco Cash Cards, Costco Credit Cards and American Express. Departments, products and services may vary by location.

youre invited to join!

Shop with complete confidence.
Youll appreciate the quality and value of the products you find at Costco. Thats our promise to you. If we fail to deliver on that promise, well refund your money. Its that simple.
Costco accepts cash, checks, EBT, debit/ATM cards, Costco Cash Cards, Costco Credit Cards and American Express.
Product selection may vary.

CostCo Gold star & ExECutivE mEmbErship appliCation CostCo awarEnEss CodE: 62000 awarEnEss
Please include sales tax in AZ, HI, NJ, NM, NY, UT, WI, plus all other applicable states. Fees are subject to change. are subject to change. Please include sales

MeMbersh p nuMber M e M b e r s h iip n u M b e r

ExEcutivE mEmbErship withaan annual (up to $750) on most to $500) on most costco purchases ExEcutivE with 2% Reward 2% reward (up Costco purchases is a $50 membership fee a year $55 upgrade fee a $50 upgrade fee a year. Limit one Executive Membership per household or business. See the membership counter for details. is $55 a year plus an additional plus an additional year. Limit one Executive Membership per household or business. Gold $55 Gold star mEmbErship is $50 a year. YEs! want to learn more about the trueEarnings card from costco and american Express. See the membership counter details. YEs! ii want to learn more about the trueEarnings card from costco and american Express. See the membership counter for for details.
Date OF BIRtH Date OF BIRtH Last Name Last Name LegaL FIRst Name LegaL FIRst Name

mI

mI

NIckName (Name tO pRINt ON memBeRsHIp caRD) NIckName (Name tO pRINt ON memBeRsHIp caRD)

Name suFFIx (OptIONaL) Name suFFIx (OptIONaL)

Jr Jr

sr sr

II II

Other Other

HOme maILINg aDDRess HOme maILINg aDDRess

cIty cIty

state state

zIp cOuNtRy zIp cOuNtRy

(aRea cODe) HOme pHONe (aRea cODe) HOme pHONe

emaIL aDDRess Receive special offers from costco.com. e-maIL aDDRess Receive special offers from costco.com.

DRIveRs LIceNse NumBeR * DRIveRs LIceNse NumBeR *

state state

Free HouseHold Card (optional) A Household Card is available to a Primary Cardholders spouse, domestic partner or immediate family member over the age of 18 and living Free HouseHold Card (optional) A Household Card is available to a Primary Cardholders spouse, domestic partner or immediate family member over the age of 18 and living at the same address. Household Cardholders will be asked to present proof that they live at the same address as the Primary Cardholder. at the same address. Household Cardholders will be asked to present proof that they live at the same address as the Primary Cardholder.

Date OF BIRtH Date OF BIRtH

Last Name Last Name

LegaL FIRst Name LegaL FIRst Name

mI
mI
DRIveRs LIceNse NumBeR* DRIveRs LIceNse NumBeR*

NIckName (Name tO pRINt ON memBeRsHIp caRD) NIckName (Name tO pRINt ON memBeRsHIp caRD) state state

Name suFFIx (OptIONaL) Name suFFIx (OptIONaL)

Jr Jr

sr sr

II II

Other Other

save time and postage Check here to automatically renew your annual membership on your American Express Card. Costco may receive updated card account information from save time and postage American Express if you have renew yourhave your new Costcoon your American Express Card. Costcobilledreceive updated card account information from Check here to automatically chosen to annual membership annual membership fee automatically may to your card account. American Express if you have chosen to have your new Costco annual membership fee automatically billed to your card account.
Costco is continually developing new and exciting programs and services at substantial savings for our members. Costco is continually developing new and exciting programs and services at substantial savings for our members. Check here if you do not want your name, postal address, email address, and membership number and status shared with carefully selected partners so they may qualify you for these offerings. Check here if you do not want your name, postal address, e-mail address, and membership number and status shared with carefully selected partners so they may qualify you for these offerings. Check here if you do not want your household Cardholders information shared as well. Check here iflicense number is your household Cardholders information shared as well. to write checks at Costco, we do need your drivers license number. you do not want not mandatory to gain membership at Costco, but if you plan *Your drivers *Your drivers license number is not mandatory toacceptance of Costcos Privileges and Conditionswrite checks at Costco, we doprivacyyour drivers license number. are available at the membership counter note: Completion of this application constitutes gain membership at Costco, but if you plan to of Membership, including our need policies and practices, which note: Completion of this application constitutes acceptance of Costcos Privileges and Conditions of Membership, including our privacy policies and practices, which are2 months after expiration of the or online at Costco.com. Please provide your Household Cardholder or any additional cardholders with this information. renewal policy Memberships renewed within available at the membership counter or online at Costco.com. Please provide your Household Cardholder or any additional cardholdersrenewed more than 2 months after such expiration will berenewed within 2months from the renewalof the current membership year will be extended for 12 months from the expiration date. Memberships with this information. renewal policy Memberships extended for 12 months after expiration date. current membership year will be extended for 12 months from the expiration date. Memberships renewed more than 2 months after such expiration will be extended for 12 months from the renewal date.

memBeRs sIgNatuRe (required) memBeRs sIgNatuRe (required)

Date Date

11/1/11 _base 3/09 _base

GWINNETT AURORA VILLAGE

99

GWINNETT COSTCO

ST 5TH 20

23

VD BL E 5 LIT L TE SA SR-104

85

AURORA AVE N/HIGHWAY 99 RD ELL IDD WL

DR RE TU N AURORA VE

MOUNTLAKE TERRACE EDMONDS FERRY EXIT

HILL SANT PLEA

VILLAGE COSTCO

EXIT

177

200TH ST

3980 Venture Drive 1175 N. 205th St. Seattle, WA 98133 Duluth, GA 30096
12C0133_A 11/11 11C0614 2/11

VE REYNOLDS STE

Patricia Frempong * E-mail: w187mkt@Costco.com* (404)664-4444

RD

For MorE InForMATIon ABouT CoSTCo, ConTACT: