USA Co-ops Community Impact Story by NCBA CLUSA

USA Co-ops Community Impact Stories

presented by NCBA CLUSA

Thank you for participating in NCBA CLUSA’s Co-op Storytellers movement! We are excited to hear about the amazing work your co-op is doing in the community.
About Co-op Storyteller
Cooperator Name*

First NameLast Name
E-mail*
Co-op/Work Title*
Staff title, Board Director, worker/owner
Co-op Name / Co-op Organization*
Co-op Web Address*
e.g. ncba.coop or n/a if none
Co-op Location*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Which co-op sector are you representing?*

AgricultureAssociation of Co-opsBank/CDFICo-op DeveloperConsumerCredit UnionGroceryHealthcareHousingInsurancePlatformProducerPurchasingUtilitiesWorkerOther
Were you referred by someone? If yes, please type their Full Name and their Volunteer Council name.
Twitter/X social media address
Instagram social media address
LinkedIN social media address
YouTube social media address
About The Co-op Story
Which co-op story elements are present in the story submission?*

IMPACT to local communityPrinciple 6 - cooperation among cooperativesInclusive economies - low-income neighbor empowermentInclusive economies - diversity community empowermentAdvocacy - engaging with elected officialsFunding supported - program/initiative createdMarketing - amplifying the co-op business modelOther
Please share the time period (month and year) when this initiative occurred or was launched*
Please share the funding source (government, grant, program, etc.) that supported your co-op and/or funded this specific initiative.
Please share if you received funding for this initiative that was created to empower/support low-income neighbors (an example is SNAP or pricing discounts). The source of the funding can be federal/state/local government or a private entity.

Yes - federal governmentYes - state/local governmentYes - private entityNo - not applicable
The Co-op Story Submission
Submission type

Self submissionNCBA Staff member at an event
Video Upload*

Cancelof
Additional media #1 (video, picture, documents)

Cancelof
Description of submission
Co-op Storyteller Consent & Waiver
LIABILITY WAIVER: By submitting this video, I acknowledge and agree that NCBA CLUSA shall not be liable for any claims, demands, actions, or causes of action arising out of or in connection with the use, editing, or broadcasting of the video content. I release NCBA CLUSA from any liability or legal actions as a result of the use, display, distribution, or publication of the video content. This waiver extends to my heirs, executors, administrators, or assigns.*

I consent to submit
Consent Release: By submitting this video, I consent to having the video content shared with Dot.Coop and the USDA for their co-op success stories projects. I understand that these organizations may use, edit, and broadcast the video content for promotional, educational, and other lawful purposes, and I grant them permission to do so. I waive any right to inspect or approve the finished product wherein my likeness appears and waive any right to royalties or other compensation arising from or related to the use of the video by Dot.Coop and the USDA.*

Consent to USDA & DotCoopConsent to USDA onlyConsent to DotCoop onlyConsent to neitherOther
Should be Empty:

About Co-op Storyteller

About The Co-op Story

The Co-op Story Submission

Co-op Storyteller Consent & Waiver