Membership Application

Thank you for your interest in joining the Black Pride Network! We will review applications on a rolling basis and respond within ten business days of submission. Once approved, we will send you an invoice (if applicable). Once the invoice is paid (if applicable) and we obtain a picture or logo, we will add you to the “Our Members” section of our website.

Name

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Organization Name

For individuals and students enter "N/A"

Website

http://

Membership Type

Read about the membership types at www.blackpridenetwork.org/membership.

Phone

(###)

###

####

Are you interested in joining the board or a committee?

Membership Agreement

Do you accept the terms and conditions outlined in the membership agreement (www.blackpridenetwork.org/membershipagreement)?

Any other information you would like to share?