Fairfield CoLab Membership Application

Name *

E-Mail *

Phone # *

Mailing Address *

I am:a remote workera freelancer/small business ownera student

Briefly describe what you plan to do in the CoLab *

Check all that apply (Cmd or Ctrl click to select multiple answers): *My work is quietI use the phone a lotI plan to use CoLab during business hours (9-5)I plan to use CoLab after hoursI plan to use CoLab on weekends

Will you have clients/visitors in the CoLab? *YesNo

How Did you hear about the CoLab?: *Select OneFacebookWalked-byNewspaperFriendOther

What Type of Space Are You Most Interested In *Flexible Space (Base Membership)Dedicated DeskPrivate OfficeNot Sure

Do you have any questions, concerns, or is there anything else you want to tell us?