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Contact Information
First Name
*
Last Name
*
Email
*
Phone Number
*
Membership Interest
*
How can we help you?
I would like more information about membership packages & prices
I would like schedule time for a tour
I am ready to sign up for membership
Organization Type - Memberships
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Which describes you
Please Select
College Student
Entrepreneur or Freelancer
Community Member
Small Business Owner
Non-Profit
Government or State Agency
Start-Up
Other
Industry Category
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What industry do you work in?
Please Select
Health / Wellness
Multi-media (All Forms)
Visual Artist
Designer (All Types)
Technology/IT Field
Small Business Owner
Financial
Food & Nutrition
Other
Annual Income - how much do you make per year before taxes?
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$0 to $35k
$35k - $55k
$55k and above
Anticipated Start Date
When are you looking to potentially start membership??
Year
/
Month
/
Day
Anticipated Usage Hours
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How many days per week do you need workspace
1x Day per Week
2-3 Days a Week
5 Days per Week
7 Days a Week - 24/7 Access
Work Hours
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When do you anticipate using the space most?
1st Shift (7am - 3pm)
2nd Shift (3pm - 11pm)
3rd Shift (11pm - 7am)
Weekends
Team Members
*
Will it just be you applying for membership or do you have others on your team?
Please Select
Just Me !
1x Team Member
2x Team Members
3x or More Team Members
Utilization Plan
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How do you plan on utilizing our shared workspace?*
Client Meetings
Daily Work Site
Equipment Rentals
Event Space Rentals
Educational Workshops
Retail Marketplace - Sell Product
Photography Studio
Other (Please specify below)
Additional needs
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In addition to workspace, check all needs that apply:
Creative & Design Work (Websites, Logos, & Business Cards Etc)
Business Coaching
Dedicated Desk
Mail Service
Storage
Landline Phone Number
24 Hour Access
Other
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