Cooperative Maine - ONLINE REQUEST FOR ASSISTANCE

Starting a cooperative?  Have an existing cooperative?  Need assistance?  Tell us what you need and we will be in touch!  We can help you connect with available resources statewide, regionally, and nationally!  Thanks!
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Your NAME
Who should we contact?
Your TITLE
(if applicable)
Name of GROUP, PROJECT, or COOPERATIVE
STREET Address
Town / City
ZIP Code
PHONE
EMAIL
WEBSITE
Briefly describe your business or business venture
What do you need help or assistance with? What services are you requesting from Cooperative Maine?
As a result of Cooperative Maine's assistance, what outcomes are you seeking?
Who are your members or potential members?
What member needs do you want met? Please describe proposed or provided products and/or services.
Please check all that apply. You have done:
Would you please send us a copy of this work so that we can assist you better?
Clear selection
 Do you have samples of promotional materials and descriptions of products and/or services that you can send us?
Clear selection
What obstacles currently prevent or inhibit the objectives you want?
What resources do you have (either internal or external) to help achieve your objectives currently? Please check all that apply.
If you have Steering Group members, please list two, below.
1) Steering Group Member-Name
1) Phone
1) Email
2) Steering Group Member-Name
2) Phone
2) Email
 Has one or both of the Steering Members listed above agreed to be founding members of the co-op board?
Clear selection
How long have you been meeting with Steering Members?
How often?
Is there any other information you'd like to share with Cooperative Maine about your endeavor or goals? If so, use this space.
How did you hear about Cooperative Maine? Please check all that apply. Through a:
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