Worker-Owned Enterprises Academy Application
To apply for the Worker-Owned Enterprises Academy, complete the form below.  All fields are required.

Please visit www.catalystmiami.org/workerowned for full program information or contact De'Sean Weber at DeseanW@catalystmiami.org if you have any questions.

NOTE: THE DEADLINE FOR ALL APPLICATIONS IS FRIDAY, MARCH 11, 2022.

 
Sign in to Google to save your progress. Learn more
Email *
First Name
Last Name
Your Email
Your Phone Number
Street Address
City/State
Zip Code
Birth date (Month / Day / Year)
MM
/
DD
/
YYYY
Gender
Clear selection
Highest Level of Education Completed
Clear selection
Race/Ethnic Background
Clear selection
Are you affiliated with any organizations?
Clear selection
If yes to the above question, which organizations?
Do you require translation services?
Clear selection
If yes to the above question, which language?
Are you currently employed?
Clear selection
If not employed, when were you last employed?
Occupation?
Do you require other kinds of special accommodations? If yes, please list.
On a scale of 1-5 how would you rate your knowledge of business skills?
Clear selection
On a scale of 1-5, how would you rate your interpersonal skills?
Clear selection
Catalyst Miami's programs and services aim to prioritize those with an income that falls at or below the chart below. Given your family size, does your income fall at or below the amount on the chart below? Your answer to this question will not guarantee or prevent your participation in our leadership programming.
Clear selection
Income Chart
Why are you interested in worker cooperatives? If you have not heard of a worker cooperative, then please describe why you are interested in creating a small business.
What do you want or expect to learn in this academy?
In a few sentences, please describe what you want most out of a job and/or career.
How did you hear about this program?
Clear selection
Do you have any questions for Catalyst Miami?
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Catalyst Miami.

Does this form look suspicious? Report