Collective Shift Collective Submission

This form is for organizations who have already formed a collective.

Question Title

* 1. Who are you?
(This person will be the point of contact for establishing the collective)

Name

Company

Company Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Email Address

Phone Number

Question Title

* 2. What is the name of your collective?
(this can be simple or clever, but not inappropriate, please)

Question Title

* 3. What groups will be joining this collective? Please list each org by Name, Contact Name, Contact Email
(each group is responsible for completing their own Single Organization Submission Form)

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

Question Title

* 4. Anything else you'd like us to know about? Or questions you have?