Advanced Co-operative Education and Development (CEAD) Fall Workshops—ONLINE Application

Name(required)

Street Address(required)

City(required)

Zip(required)

Email(required)

Phone Number(required)

Are you impacted by Incarceration?

Have you been incarcerated?

Do You have a loved one who has been incarcerated?

Do you have a loved one who is currently incarcerated?

Have you been arrested, detained, or harassed by the police?

Do you have access to the internet? Please check those that apply?

Phone

Ipad

Computer

Have you completed the Introduction Workshops?

Yes

If so are you willing to support workshop presentations in some way?

Yes

We provide a $25 stipend for those who are not working or underemployed and from impacted communites. Do you request a stipend?

Yes

Are You available to attend all 8 workshops?

Yes

Please describe the Co-op Business Concept to be explored in the advanced workshop series(required)

Please list the other members of your team working on the same project(required)

Are you interested in Collective REMAKE's Train-the-Trainers Program so be come a future Co-op educator and facilitator?

Yes

Please explaing why.(required)

Message

Do you have other co-op business ideas to explore in the future?(required)

Other Details