Application

Cooperative Education Application

Applicant Criteria

Each team must have a minimum of 2 participants.
Each team member must complete the application form.
Each applicant must commit to attend all 8 sessions. Sessions will be recorded for future reference, but live participation is highly encouraged.
Each team must consist of members, board members, and/or staff from an emerging start-up, a converting business, or an established cooperative.
Participants must sign a participant agreement and attend an informational session on September 28, 2022. Arrangements can be made to accommodate schedule conflicts for the information session.
Participants must pay a deposit of $100 (capped at $300 per team) to be reimbursed upon successful completion of the program. Scholarships are available if paying the deposit presents a hardship.

Basic Information

* Indicates required field

Your Name *

Email *

Phone Number *

Your Group's Name *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Which Program Interests You? *

Please name any accessibility needs we need to consider (language interpretation, closed captions, etc.)? *

What core counties do prospective members reside in? *

What counties is the co-op likely to provide service to? *

Acknowledgement of Deposit *

I acknowledge that my participation in Co-op Academy requires a deposit that can be refunded upon successful completion of the program.

Note: This page can be used as a paper application. Print and email once complete.

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