Application

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Keystone Development Center

Cooperative Education Application

Pay Deposit

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 Describe Your Project of Business. Include information on how long your project has been in operation, who your potential members are, what geographical area you hope to serve, the primary need your business is filling in the community and anything else you think we should know about your project *

Please describe your project. Include information on how long your project has been in operation, who your potential members are, what geographical area you hope to serve, the primary need your business is filling in the community and anything else you think we should know about your project

What do you hope to achieve by enrolling? *

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How did you hear about KDC? *

Referral Google Search Other Cooperative Development Meeting Other

What has your group already completed? *

Formed Steering Committee Feasibility Study Marketing Study Written Business Plan Elected a Board of Directors Adopted a Set of By-Laws Begun an Equity Drive Incorporated The Business

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Which stage of development is your business in? *

Exploratory Organizing Operating

Are you seeking a scholarship? *

Yes No

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

Program Information

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.

Submit

Request Assistance

KDC is supported through grants from the USDA Rural Cooperative Development Grant program.
USDA is an equal opportunity provider, employer, and lender. To learn more, please visit www.usda.gov

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Cooperative Education Application

Basic Information

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