Organization Information & Background

Primary Contact Information

Primary Contact Email

Website

http://

Social Media Handle(s)

Year Established

Mission Statement

Organizational Background

Number of Full-time/Part-time Staff

Existing Partners or Affiliations

Annual Organizational Budget

What is your current space situation and what would you like it to be?

In what ways do you envision contributing to BLACspace’s mutual aid and resource-sharing model?

(Please describe any knowledge, skills, or resources your organization can offer fellow members (example: event space, office space, grant writing, mentorship, funding opportunities)

Which of the following areas are you seeking support with?

If you answered "Other" to the last question, please specify here

What are the top 3 specific challenges or pain points your organization is currently facing?

Has your organization ever participated in any capacity-building or coaching programs? If yes, please describe.

What are your organization’s short-term and long-term goals?

Why are you interested in joining BLACspace Cooperative Membership?

(Please explain how you hope membership will benefit your organization, and how you hope to contribute to the network.)

BLACspace Cooperative Membership requires active participation. Can your organization attend the full program calendar?

Yes / No (If no, please explain). See calendar

After a year of active participation, members gain governance rights including board selection and member policies. Please describe your experience with and interest in cooperative decision-making.

Please share a reflection, question or concern about these shared assumptions.

Is there anything else you would like to share that would help us understand your organization’s needs, goals, or fit with BLACpace Cooperative?