Personal Information First Name * Middle Name Last Name * Email Address * Phone Number Street Address * City * State/Province * Postal Code * Co-op Connection Are you a member of a co-op or organization that is a member of NASCO? * Yes No Please note that we are collecting this information for reporting purposes, but it will not determine whether a scholarship is awarded. Please select your co-op from this list: - None -4th Street Student Housing CooperativeBitternut CollectiveBloomington Cooperative Living (BCL)Boulder Housing CoalitionCambridge Cooperative ClubCampus Co-operative Residence (CCRI)Central PA Community HousingChateau Housing CooperativeCo-op Housing University of Maryland (CHUM)College HousesCommunity Housing Expansion of Austin (CHEA)Community of Urbana Cooperative Housing (COUCH)DeCleyre Cooperative HousingEast River CooperativeEvergreen Co-opFranklin Student Housing CooperativeHorizontal HousingHouston Access to Urban Sustainability (HAUS)ICC Ann ArborICC AustinKalamazoo Collective HousingKeent Cooperative HousingMadison Community CooperativeMarcy Park Co-opMarquette Climbers' CooperativeMarshall Student Housing Co-opMATCHMOSAICMSU Student Housing Cooperative (MSU-SHC)Nickel City Housing Co-opOberlin Student Cooperative Association (OSCA)Portland Collective HousingQueen City CooperativeQumbya Housing CooperativeRed Clover CollectiveRiver City Housing Collective (RCHC)Rosewood Housing CooperativeSanta Barbara Student Housing Cooperative (SBSHC)Solar Community Housing AssociationStewart Little Co-opStone Soup CooperativeStudents' Cooperative Association (SCA)Student Cooperative Organization (SCO)The Beet CollectiveThe HiveThe Hearth (Coaching House)The MiddenUniversity Cooperative Housing Association (UCHA)Unitarian Universalist Community Cooperatives (UUCC)University of Kansas Student Housing Association (UKSHA)Waterloo Co-operative Residence Inc. (WCRI)Weaver Community Housing AssociationWhitehall CooperativeWood St.Woodnote What co-op/organization are you affiliated with, if not a NASCO member Is your co-op * Urban Suburban Rural Are other members of your cooperative attending Institute this year * Yes No I don't know Have you attended NASCO Institute before? * Yes No Financial Information Are you a student? * Yes No Do you have any dependents? * Yes No How many dependents do you have? What is your annual income before taxes (in US dollars)? * $ Do you receive regular financial support from other sources, not reported in your annual income? I.e. Do your parents or someone else support your rent, food, tuition, health insurance, etc. * Yes No If yes, please explain Are there other financial considerations that we should be aware of? Are you anticipating any other financial barriers to attending an in-person conference? If so, please explain and estimate the associated cost. How much in $USD are you able to contribute to your NASCO Institute registration and travel costs? * $ How much in $USD are you requesting in order to attend NASCO Institute 2023? * $ Marginalized Identities Do you identify as a member of any of the following identity groups? Person of Color? * Yes No Person with Disabilities? * Yes No LGBTQIA2S+? * Yes No International Student (studying outside of your home country)? * Yes No Is there additional information about your identity you would like to share for this application? Short Response Prompts Is there any information that you would like to share with us that wasn't covered in the application? Co-op Development Are you starting a co-op or expanding a currently existing co-op? * Yes No What type of co-op are you starting/expanding? How many members will you serve? Who is leading this project? What is your role? What is the next big step? Leave this field blank Submit
