Cooperative Academy Spring 2024 Application

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Please fill out the following application for our Co-op Academy. You will be contacted by the Southeast Center for Cooperative Development if you have been selected for this free class.
Spring 2024 classes start on Tuesday February 6th and go from 6:00 pm to 8:00 pm CST and end on April 16th. For this Academy, most of our meetings will be in person in Brownsville, TN. For teams from the Metro Nashville area, we are working on a potential meeting location for you to gather in person. Groups attending from other locations will attend virtually via Zoom (computer and wi-fi access necessary).

Aplicación en Español: https://forms.gle/pBx3ZHL5hBvt7mPS9

Email *

First and Last Name *

Email *

Cell phone number *

Address *

Street or P.O. Box, City, State and Zip Code

Which category describes you best? (Please select all that apply.)

American Indian/Indigenous

Asian

Black or African American

Hispanic/Latinx

Native Hawaiian or other Pacific Islander

White/Caucasian

Other race, ethnicity, or origin

Option 8

Clear selection

What best describes your gender?

Female

Male

Non-binary

Prefer not to say

Other:

Clear selection

What is your age range?

Under 18 years old

Between 18 and 24

Between 25 and 35

Between 36 and 45

Between 46 and 55

Over 55

Clear selection

What is your occupation?

What is your employment status?

Working full time (more than 30 hours/week)

Working part time (less than 30 hours/week)

Unemployed

Full time student

Other:

Clear selection

What is your annual income level?

Less than $15,000

Between $15,000 and $34,000

Between $35,000 and $49,000

Between $50,000 and $75,000

Greater than $75,000

Prefer not to say

Clear selection

This income supports ... (Please check all that apply.)

1 adult

2 adults

3 or more adults

1 child

2 children

3-4 children

5 or more children

Have you been previously incarcerated? (This will not exclude you from the course. We are interested in working with people who have been marginalized from entrepreneurship and/or financing.)

Yes

Prefer not to answer

Clear selection

Are you receiving public assistance such as SNAP benefits? (We are interested in working with people who have been marginalized from entrepreneurship and/or financing.)

Yes

Prefer not to answer

Clear selection

Have you previously owned a business?

Yes

Clear selection

Tell us about your cooperative business or cooperative business idea

What kind of business is it? Ex. restaurant, house cleaning, landscaping, etc.? How many members do you have? When was it formed?

Please list the names of expected co-op members participating on your team. We suggest a minimum of 2 participants. (You and at least one other person should be working on the same cooperative business idea. All team members must apply individually using this form.)

Tell us a little about yourself and your core group members such as your experience in starting a business or experience in an area useful for your business idea, where you live, your education level, race/ethnicity, gender, income level, etc.

Please explain the stage that your co-op or business idea is at currently. Do you currently run a business? What is its incorporation status? Do you have part time and/or full time employees? Are you home-based, virtual, separate brick and mortar business?

Does anyone in your group need interpretation (spoken) or translation (of written materials)? If so, which languages?

You and our group members need to be committed to attending all Tuesday evening sessions from 6:00 pm to 8: 00 pm CST and completing some tasks during the week on your own. Can you commit to these requirements?

Yes

Maybe

Clear selection

This class will be held in a hybrid format: in person for teams in the Brownsville, TN area and virtual through Zoom for groups living out-of-town. We are working on a possible in-person option for this in Metro Nashville too. If you are able to commit to any of the options, can you let us know what you'd prefer?

Joining online

Joining in-person Brownsville, TN

Would like to join in person in Nashville, TN (we cannot guarantee this option)

Other:

How did you find out about us?

Website

Friend/Family member referral

Facebook/Instagram/Twitter

I am a former SEC4CD student.

Other:

Clear selection

Thank you for applying to the Co-op Academy. We will contact you with more information and the Zoom links before classes start. Check out the FAQ page at http://bit.ly/FAQacademy or our website at www.co-opsnow.org if you would like more information. Have any last questions? Write them below and we will get back to you ASAP.

Send me a copy of my responses.

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