Worker-Owned Business - Academy Application

The Worker-Owned Business Academy is designed for teams in the idea, pre-launch, or early start-up stage. We ask that groups apply with at least 3 members. From experience, co-ops with three or more people are better equipped to share responsibility, make informed decisions, and establish a strong foundation for sustainability.

Each member of your team must fill out this application. This allows us to learn about your individual background, perspective, and interest in the program.

Basic Information

First Name *


Last Name *


Email *


Phone *

Preferred Pronouns *

She/Her

He/Him

They/Them

What is your preferred language? * --None– English Spanish Haitian Creole

What are your preferred method(s) of contact?

Email

Phone Call

SMS Text

Street *

City *

Zip Code *

State *


Catalyst Miami's programs and services aim to prioritize those with an income that falls at or below the income level indicated in the chart below.
Given your family size, does your income fall at or below the amount on the chart below? *
Your answer to this question will not guarantee or prevent your participation in our programming.
--None-- Yes No

Demographic Information

To understand why we collect all of this data, please click here.

What race do you identify with? * --None-- American Indian or Alaska Native Asian Black or African American Indigenous (Non-Native American) Native Hawaiian or Other Pacific Islander White Multiracial Other Prefer not to answer

What ethnicity do you identify with? * --None-- Hispanic Non-hispanic Other Prefer not to answer

What gender do you identify with? * --None-- Male / Cis Man Female / Cis Woman Non-binary / Gender fluid Trans man Trans woman Other Prefer not to answer

When were you born?

What is your employment status? --None-- Full-time Part-time Contract Disability Furloughed Retired Seasonal/Temporary Self-employed Student Unemployed Volunteer Prefer not to answer

What is your current health insurance status? --None-- Insured Uninsured/No health insurance Jackson Card/Jackson Charity Care Do not know Prefer not to answer

Household size, including yourself


Estimated Annual Household Income

To make your experience as comfortable and inclusive as possible, please let us know if you requiere any of the following accommodations.
You will be contacted by a Catalyst Miami staff member to discuss your specific needs.

Accompanied by a service animal

Child Care

Interpretation Services

Materials in large print

Other (specify below)

Recap Notes

Wheelchair Accessible

If you marked “Other (specify below)” in the question above, please, specify here what special accommodations you require.

Cooperative Information

Who else is a part of your co-op team? *
List the other members' full names here. When your team members fill out their form, make sure they remember to add your name in this question, too!


Your Co-op's Name (if you have one) *
If you group hasn't chosen a name yet, just write TBD


Tell us briefly about your co-op idea. What does your group want to do together? *
(For example: the type of business, the community you want to serve, or the problem you want to solve). We welcome co-op ideas of all kinds!

What stage best describes your co-op? It’s okay if you’re just starting out — that’s what the Academy is for! * --None-- Just an idea we’re exploring We’ve started meeting and planning We already work together informally We are operating as a business (early stage) Other (please explain)

If you marked “Other (please explain below)” in the question above, please, explain here what stage best describes your co-op.


What interests you about worker cooperatives?
(For example, is it the shared ownership, teamwork, or something else?)


What excites you about being part of this co-op, and what challenges do you think your co-op might face? Share from your own perspective.

How much do you know about how to run a business? --None-- No/almost no knowledge Little to some knowledge Knowledgeable Advanced Knowledge Expert Level Knowledge

How much do you know about teamwork and working with others? --None-- No/almost no knowledge Little to some knowledge Knowledgeable Advanced Knowledge Expert Level Knowledge

Please share any information you think might help us better serve you.

Referral Information

How did you hear about us? *


Are you affiliated with any organization in South Florida? If yes, please share their names below

Submitting your Form

After you click Submit, you will receive an email with next steps. We will contact you as soon as possible.

*If you are also interested in assistance with services like Financial Coaching, Health Insurance Enrollment, or Small Business Assistance, click here to request an appointment.

By submitting this application, you are OPT-IN and are consenting to receiving SMS text messages from Catalyst Miami for appointments, events and general outreach purposes at any time while inquiring about or receiving services. Message frequency may vary. You may reply STOP to opt-out of future messaging at any point. Reply HELP for more information. Message and data rates may apply.

We do not rent, lease, or sell customer lists or any data collected on our site to third parties. Catalyst Miami does not sell, share, or lease personal information with third parties for marketing/promotional purposes.

Click here to see our Privacy Policy.

"By submitting this application, I attest that the information I am providing is true and correct."