Supporters Questionnaire

Important: Please answer all questions marked with a red asterisk (*).


Email Address: *
First Name: *
Family Name: *
Year of your Birth: *
Gender: *
Country: *
City/Town: *
Postcode: *
Phone Number: *
Profession: *
Single or Partnered: *
Children: *
(please list name, gender and year born for each one)
Where did you hear about Kanjini Co-Op? *
Your answer to this really helps us, thank you.


Please Note: your answers will be treated as an indication only and not a definite commitment

Do you consider becoming a member of Kanjini Co-Op, and if yes when? *
Is your potential membership for a Full Share OR an Introductory Share? *
What percentage of that Share capital can you pay upfront (as a deposit)? *
Could you help to manifest the vision by purchasing additional Investment Shares? *
Do your envisage /plan to be a full year resident, part-time or a visiting member? *
Do you see yourself being a resident on Kanjini Co-Op land and if yes when? *


(all answers in this section are optional)

Do you have any previous experience of cooperative or communal living?
(If yes please describe briefly)

What skills and trades would you wish to contribute when living on Kanjini Co-op land?
Would you be willing and able to help right now to make the Kanjini Co-Op vision become a reality and if yes which skills can you offer for that?

If yes, how much time can you contribute?
Can you volunteer to help with any of the following tasks right now, to help make the Kanjini vision a reality? office work
building design
landscape design
farming design
planning applications
impact studies
other promotion
graphics work
website development
research (eg internet)
Are there any other ways you can envision yourself supporting the Kanjini Co-Op vision?
(please use this space to also expand on your above volunteering choices)
Any further comments or feedback:
I would like to get access to the Kanjini Supporters & Members website * Yes No
Please enter the code shown above:
Please Note: It is vital that your e-mail address is correct - or we cannot get back to you!