Greater Houston Retailers Cooperative Association, Inc.

GREATER HOUSTON RETAILERS CO-OPERATIVE ASSOCIATION, INC
12790 South Kirkwood Road, Stafford, Texas -77477
Phone: (281) 295 5300 Fax: (281) 295 5399
Authorization Letter for New Member Orientation
I, _______________________________________ am an authorized representative / officer of
the store name __________________________ located at _______________________________
______________________________________________________________________________
Select any one option
□ I authorize my manager ___________________________ Cell Phone # _______________
to act on my behalf, for New Member Orientation at the above store location. I understand that I
will still be liable at all times, fulfilling the requirements of the GHRA policies, guidelines,
regulations and duties.
This document does not authorize any voting rights, changing or modifying any membership
information, or substituting any of the duties related to authorized representative or officer.
□ I will be available to participate for orientation at the above store location.
Signature: (Authorized Representative) _____________________ Date _______________
Cell Phone # _________________________ Alternate Phone # _________________________
Note: Authorized Representative is referred to as; please see application Page 1 of 5 (between
line 11a and 12) for detail explanation
For GHRA Office Use Only
Approved by Name: __________________________________Title: _____________________
Signature: __________________________________________ Date: ___________________
Notes: ________________________________________________________________________
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