JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Office Hours Appointment Form
If you are a member of a co-op in need of assistance during this time, please fill out the form to the best of your ability. We will be in touch to set up an office hour appointment as soon as we can.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
What is the name of the co-op seeking assistance?
*
Your answer
Name of the primary contact?
*
Your answer
Email of primary contact?
*
Your answer
Where is the co-op located?
*
Your answer
Who are the co-op member-owners?
*
Workers
Consumers
Producers
Multi-stakeholder
Residents
Other:
In what sector does the co-op operate?
*
Grocery
Childcare
Healthcare
Restaurant/Retail
Energy/Utilities
Housing
Agriculture
Other:
What stage of development in the co-op in?
*
Organizing
Start-up
Operational
Other:
What would your co-op like assistance with? Check all that apply.
*
Business planning and budget management
Applying for the Economic Injury Disaster Loan/Paycheck Protection Program
Applying for other emergency loans
Other:
Required
Anything else you'd like to us to know about your co-op?
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of CooperationWorks!.
Report Abuse
Forms
