The Careshop Health & Wellness Co-working Application

Membership Application
Business Name*
Authorized Officer First and Last Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*

Area CodePhone Number
Email*
example@example.com
Years in Business*
Business Industry*
What date would you want to begin your membership*

Tell us about your business journey*
What sets your business apart from others in our community*
How does a health and wellness co-working space membership fit into your business vision*