Join our co-op and make it yours. Basic Information Applicant Name* (organization or individual) Applicant Type* IndividualCommunity Economic Development CenterCooperativeCooperative Development CenterFederation/AssociationLoose NetworkOther [group org-type-selected inline]Other Type [/group] How do you contribute to the movement for a cooperative economy?* Street Address #1* Street Address #2 City* State/Province* Zip/Postal Code* Country* Phone* Website Organizational or individual email* [group org-selected] Organization Infomation For organizations, please give the name and contact information for a person to contact with DCC information and business. Liaison Name* Liaison Email* Liaison Phone* Are you a cooperative? YesNo Do you own a .coop domain? YesNo [group own-domain].coop Domain Name [/group] Who are your organization’s owners? (Ctrl/Cmd for multiple selections)WorkersProducersConsumersBusinesses/OrgsInvestorsNon-profit/NGOIndividualUndetermined/noneOther [group owner-type-selected inline]Other Type [/group] [/group] Board Readiness The Board of Directors is elected by the co-op’s members. Serving on the board is a good way to make sure the voice of a community is heard clearly. Please let us know if you or someone from your organization is…---Interested in serving on the boardCould perhaps be convinced to serve on the boardNot interested in serving on the board at this timeNot interested in serving on the board at this or any other timeWill serve for chocolate Dues Membership dues are calculated as a percentage of a year’s expense budget. What counts as an expense budget, you ask? We leave that up to your judgment. Some large organizations have chosen to limit this number to the department or grant relevant to Data Commons Co-op activities. The sliding-scale dues formula is as follows: Start with your expense budget for the last year. Calculate 0.1% of this number for your projected dues. If this is less than US$100, either apply the US$100 minimum or request a waiver. Your first year’s annual dues includes the purchase of one membership share at a book value of US$1 and each year's dues count as equity investment. Your application is reviewed without consideration of dues, and we look for funds as needed. Other members have chipped in extra to fund low/no-budget grassroots organizations. Your currencyUS DollarsCanadian DollarsMexican PesosEurosBritish PoundJapanese Yen Request waiverNoYes Amount of waiver requested Your calculation of projected dues (including waiver) Support other organizations (optional) Can you support low/no-budget grassroots organizations that wish to join but can’t make the dues? If so, add your donation type and amount below. Thank you! What type of donation is this?One timeRecurring annually Amount (US$) —Please choose an option—$100$300$500$1000Other [group waiver-contrib-selected inline]Other Type[/group] Agreement The liaison(s), on behalf of the applying organization, agrees to abide fully by the Data Commons Cooperative articles of incorporation, bylaws, and rules and regulations, including the data-sharing privileges and limitations defined in each data contributor’s data license. If the application is accepted, membership will take effect when approved by the Board of Directors at a regularly scheduled monthly meeting. The membership fee will be due on September 1st of each year. The fee will be pro-rated appropriately the first year. Do you agree to these terms?YesNo