Credit Forms

Please select the form(s) you would like to submit below and return to North Wellington Co-op as per the instructions on this page.


If you have any questions about these forms please contact our Credit Manager, Jackie Ziegler at 1-800-667-3056 or 519-338-2331.


Your privacy is important to us. Please submit your form(s) in any of the following ways:

By mail addressed to:
Jackie Ziegler
North Wellington Co-operative Services Inc.
56 Margaret Street South
PO Box 700
Harriston ON N0G 1Z0

In person:
Placed in a sealed envelope marked “Attn: Jackie Ziegler” to any North Wellington Co-op branch.
If you would like to deliver your completed form(s) in person, please call to set-up an appointment with Jackie Ziegler at 1-800-667-3056 or 519-338-2331.

By fax:
With a cover page “Attn: Jackie Ziegler” to 519-338-3513.
The original signed copy must also be submitted by mail or in person, as above.