Technocopia Community Member Application
Technocopia provides eight community memberships annually to people who meet certain specifications and are interested in making and using the resources of our shops. The membership is free of cost and can be held for one year or more, in accordance with specific guidelines. Applications can take up to 30 days to process, and an in-person interview and member orientation are required to complete the process. If you have any specific questions please email: lauren.monroe@technocopia.org. Otherwise please read through the requirements and fill out the information below.

Individuals must:
- be a resident of or work in the city of Worcester
- be age 18 or over
- be in financial need

Special attention will be given to those who:

- Have a defined interest in engaging in the maker community at large, and with Technocopia specifically
- Contribute to the diversity of the maker space by means of race, age, sex, gender identification, or skill set
- Contribute to other local community outreach or partnerships


Contact Info
Name (Last, First) *
Your answer
Phone *
Your answer
Email *
Your answer
Home Address *
Street, City, State, Zip
Your answer
Emergency Contact
In the event of an emergency, the first person we should notify.
Name *
Your answer
Relation *
Your answer
Phone *
List more than one if necessary.
Your answer
Membership
Membership Type *
Do you find the basic $75/month membership fee challenging for your current household income to sustain? *
Volunteering *
Technocopia is a member and volunteer driven community. We are always in need of volunteers for our non-profit organization. Please select if you have any interest in volunteering with us.
If yes, in what area would you like to get in involved? *
Code of Conduct
*
Required
Community Relations *
It is important that our members have a history of good relations in maker spaces they have worked with in the past. Do you have any outstanding grievances or accusations of foul/misbehavior in past maker spaces in or outside of the state of MA? If yes, Technocopia staff may need to meet with you before your application for membership can be further processed.
Community Membership Agreement *
As part of this membership agreement, community members granted membership under this program, will be given a contact person for communicating needs, concerns, or reasons for prolonged absence from the maker space. Community members do become in danger of losing their membership if they are unable to complete classes or trainings, or are otherwise inactive in the space. By checking yes you are agreeing to communicate reasons for prolonged absences to a Technocopia member contact.
What do you want to make? *
In a few sentences please describe how you hope to use the Technocopia maker space. What shops, tools, or trainings do you hope to engage in?
Your answer
Community Involvement *
Are you involved in any other community projects in the city of Worcester? If yes, in a few sentences, please describe your community involvement.
Your answer
Reference *
Please provide the name and phone number of two references who can speak to your work or community involvement.
Your answer
How did you hear about the community memberships? *
Release and Waiver of Liability
Please review our Release and Waiver of Liability agreement here:

https://drive.google.com/file/d/0B1pu25WzUJBhaHg3dUp2cEZTcG8/view?usp=sharing

*
Required
Media Release
Technocopia uses several forms of media for promotional and educational purposes such as photo, video and audio. From time to time, members may be asked to be recorded or be made aware that a recording is taking place. Recordings may be published publicly on the web or in hard copy. If a member wishes to remain anonymous or undocumented, it is their responsibility to inform whoever is conducting the recording at that time.
*
Required
Electronic Signature
I have read and understand all documents included in this form and agree to their terms and conditions.
Full Name *
Your answer
Date of Birth *
DD/MM/YYYY
Your answer
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