Colectivo Worker Sign-Up
This form is to help us locate Colectivans who have been permanently terminated in the last month due to COVID-related downsizing. Please fill out the following form in as much detail as possible so that we know where to distribute relief funds from the fundraiser. We will contact you at the end of the fundraising campaign to confirm this information.
Even if you intend to reapply at Colectivo or think you will end up donating your portion of the proceeds back to the other coworkers, please consider signing up so we can reach out when the time comes.

If you have any questions please email us at colectivocoworkers@gmail.com
Link to the fundraiser: https://givebutter.com/ColectivoWorkers
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What is your name? (Preferably as it appeared on your work schedules so that we can verify your identity/eligibility) *
Which Colectivo location or facility did you work at primarily in the months prior to your job being terminated? (If you worked across many locations, please just list the city and your job title.) *
When and how did you learn your job was being eliminated? *
What is the best way to reach you? *
Please give us your phone number and/or email.
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