Complete the census – Census 2017 | CEANYC Order Number 2017 Co-op Census What is the name of your organization? * What sector does your organization work in? 11-Agriculture 22-Electric 23-Construction 44-Food retail (grocery) 51-Information Services (publishing, broadcasting, data processing) 52-Credit Union 52-Insurance 53-Housing 54-Communications/marketing 54-Computer systems 54-Consultant 54-Co-op Development 56-Housekeeping 56-Landscaping 61-Educational Services 62-Childcare 62-Healthcare 62-Human Services 71-Arts 71-Recreation 81-Co-op Association Other Sector Is your organization owned by consumers? Yes No Is your organization owned by workers? Yes No Is your organization owned by businesses? Yes No In what state is your organization formed or incorporated? Select a State/ProvinceAlabamaAlaskaAmerican SamoaArizonaArkansasArmed Forces AmericasArmed Forces EuropeArmed Forces PacificCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUnited States Minor Outlying IslandsUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming If formed in New York, select those forms that that apply: Business Corporation Membership Cooperative Corporation Article 5A Worker Cooperative Corporation General Cooperative Corporation Agricultural Cooperative Corporation Not for Profit Corporation Limited Liability Company (LLC) Public Benefit Corporation Partnership Unincorporated Association Other Business Formation: If your organization is not formed in New York State, what is its entity type? What is your tax status with the IRS? Cooperative Corporation C-Corp S-Corp LLC Partnership 501(c)3 501(c)4 Other Tax Status Street Address * City * ZIP Code * State * Select a State/ProvinceAlabamaAlaskaAmerican SamoaArizonaArkansasArmed Forces AmericasArmed Forces EuropeArmed Forces PacificCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUnited States Minor Outlying IslandsUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming Borough * Bronx Brooklyn Manhattan Queens Staten Island Website What social media does your organization use (select all that apply) Facebook Twitter Instagram Facebook Twitter Instagram If we’d like to put a general phone number and email address for your cooperative into a public directory, which would be the appropriate line/address? General/Public Phone General/Public Email Address * Do you have other locations? What are their addresses? In 3 words or less, what does your business do? (e.g. solar installation, grocery store) In What Year Was Your Organization Legally Established? How Many Years Has Your Organization Been in Business? 0-4 5-9 10-14 15-19 20+ What Are Your Hours of Operation? What are the top 5 or so cooperatives you collaborate with? What are the organizations, coalitions or conference you interact with most (that are not cooperatives listed above)? The Cooperative Economics Alliance of New York City (CEANYC) aims to strengthen and expand community-led, democratically-controlled initiatives. Our goal is to build an economy based on values of social and racial justice, ecological sustainability, cooperation, mutualism, and democracy. Would you like more information about CEANYC membership? Yes No We'd also like to get in touch with co-op friendly technical assistance providers, facilitators, attorneys, bookkeepers, accountants, and the like. Does your organization use the services of any experts like this? Could you offer a specific name and phone number for them? Technical Assistance Providers What are some other organizations in your area that we may be missing, and should know about? Could you offer a specific name and phone number? Other Organizations Later on, we'd like to be in touch with your co-op to share the results of this survey and maintain or build on this data for the directory. What is the contact information for the right person to be in touch with in the future about this data? Data Mantenance Contact Info: First Name Data Mantenance Contact Info: Last Name Data Maintenance Contact Info: Email Data Maintenance Contact Info: Phone In the future, we'd like to be in touch with your organization about other events for cooperatives in NYC. What is the contact information for the right person to be in touch with about future events? CEANYC Events Contact Info: First Name CEANYC Events Contact Info: Last Name CEANYC Events Contact Info: Email CEANYC Events Contact Info: Phone This spring we’re beginning to offer Cooperative Leadership Institute classes and trainings taught by cooperators. Would you be interested in teaching a class or workshop or training your peers in a skill? Yes No Would you like to participate in the Cooperative Leadership Institute? Yes No Are you working with other kinds of cooperatives? Yes No If yes, what are the skills/information you could teach? If yes, what kinds of training would you like to see? What support do you need to work with other kinds of cooperatives? TwitterFacebookTumblr
