Co-Op Sign-Up: Tucson

First Name *

Last Name *

Email *

Street Address *

City *

Country

State *

Postal Code *

What Long-Term Goals do you have as a Co-Op Member?

Ability to Contribute

I am able to contribute physically I have some physical limitations I am interested in alternative volunteer options

What days of the week is the Co-Op Member generally available to participate on event days?

General Availability:

Monday Tuesday Wednesday Thursday Friday Saturday Sunday

What is the general time of day that a Co-Op Member can be available on event days?

Mornings Afternoons Evening

What skills do you possess that may be useful during a Co-Op event?

Alternative Skills:

Administrative Tasks

Other:

How did you find out about the Tucson Co-Op?

Web Media (Website, Facebook, Email, ect) Traditional Media (Flyer, Newspaper, ect) Another WMG Event Referral - Another Co-Op Member Referral - WMG Employee Referral - Other

Name of person who referred the Co-Op member to the program.

Referred by

Please list any other people earning hours for your household (Co-Op unit). List First Name, Last Name, their Email address and their relationship to you. E.g.: John Smith, john@abc.com, (spouse of) Jim Smith, jimmy@gmail.com (child of)

Additional Participants in your Co-op Unit: