Co-op Boot Camp Registration - Sept. 2017
Registration for the Co-op Boot Camp - September 2017 - DEADLINE August 24, 2017
Email address
First Name
Your answer
Last Name
Your answer
Street Address
Your answer
City
Your answer
State
Your answer
Zip
Your answer
Phone
Your answer
Ethnic Information - Check all that apply (This information is kept for statistical purposes.)
Required
Organizational affiliation (if relevant)
Your answer
Why are you interested in this class?
Your answer
Do you have experience with cooperatives? If so, please briefly describe.
Your answer
The course fee is $50. Do you need a scholarship? If so, please name the amount that you are requesting.
Your answer
Do you need a stipend in order to participate? If so, please explain your financial need (eg. to cover the cost of childcare, transportation, taking time off work, etc.). There is a maximum of $150 for attending all four classes and we have a limited number of stipends.
Your answer
Please complete the captcha before submitting the form.
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms