communi(tea) incubator application.

thank you for your interest in the OrangeMoon communi(tea) incubator.

Please complete and submit the form below.

Name

First Name

Last Name

What is your date of birth?

What is the best phone number to call and send text messages

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Are you legally authorized to work in the United States?

Are you able to commit to being in Brooklyn, NY the last 2 Tuesdays of the month for at least 10 hours?

Do you have access to a computer and wifi to complete online training?

Background Check

I authorize The OrangeMoon to obtain an investigative consumer /employee report in an effort to place me into an employment/independent contractor/volunteer relationship with the company and it's partners. The Company will only share the background report as necessary, and as authorized, in order to assign me to position within the organization. I understand that if the Company hires or engages me, my consent will apply, and the Company may obtain reports throughout my employment/contract/tenure where state law allows. I also understand that the information contained in my job application or otherwise disclosed by me before or during my employment/contract/tenure, if any, may be used for the purpose of obtaining consumer reports and/or investigative consumer reports. By electronic consent, I authorize law enforcement agencies, learning institutions (including public and private schools and universities), information service bureaus, credit bureaus, record/data repositories, courts (federal, state and local), motor vehicle records agencies, my past or present employers, the military, and other individuals and sources to furnish any and all information on me that is requested by the consumer reporting agency.

yes