10 Carden Membership Application
Page One
1.
Your Contact Information
First Name
Last Name
Title
Organization Name
Street Address
Apt/Unit#
City
Postal Code
Email Address
Phone Number
Fax Number
Mobile Phone
Website Address
2.
Do any of these words describe your organization?
(Select one or more.)
Student
Consultant/facilitator
Sole proprietor of local business
Artist
Professional
Innovator/entrepreneur
Government employee
Educator
Community advocate
Technician
Labourer
Other
3.
What sector(s) describes your organization?
(Select one or more).
Environment
Arts
Culture
Social Justice
Health and Disability
Technology
Economic Development
Public Space
Professional Association
Law
Politics
Social services
Recreation
Capacity building
Community development
Social purpose business
Advocacy
Agriculture/Sciences
Other
4.
Please rank the following factors in your decision to become a member at 10 Carden.
1=not important | 4=very important
1
2
3
4
Location
Co-Working space access
Meeting space access
Like-minded Community
Shared Services
Social Capital/Networking
Affordability
Workshops
5.
Please describe the skills/resources/experience that you could share with the 10 Carden community of changemakers.
6.
How did you learn about 10 Carden?
7.
When is your preferred start date?
8.
For those considering space rental membership at 10 Carden - how often do you anticipate booking space?
1 x per year
4 x per year
Monthly
Weekly
Multiple series of bookings throughout the year
Not sure
9.
Describe the types of organizations with which you most frequently collaborate?
10.
What is the mission/mandate of your organization/project?
11.
Please indicate which of these words best describes your organization’s legal structure
Registered Charity
Registered Not-for-profit
Incorporated Not-for-profit
Incorporated For-profit
Co-op
Partnership
Sole Proprietorship
Other
12.
How long has your organization or project been operating?
13.
How many employees/current members are there in your organization?
1
2-5
6-10
11-25
26-50
51-100
101-500
501+
14.
Please select the word that best describes your organization or project
Idea or project phase
Emerging (incorporated or in process of incorporation)
Growing (less than 2 yrs old)
Established
15.
Do you have any other information about your organization or ideas/input that you'd like to share with 10 Carden?
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