La Femme Noire Collective, Inc. Membership Application 2023-24
APPLICATIONS MUST BE SUBMITTED BY JUNE 17, 2023 11:59pm EST
Please review the Prospective Member Guide before completing this application.
First Name
Last Name
Preferred Pronouns
Select One Option
She/Her/Hers
They/Them/Theirs
He/Him/His
Ethnicity
Black: African
Black: African American
Black: Caribbean
Black Other
Hispanic: Spanish
Hispanic: Latin American/Caribbean
Asian
Pacific Islander
Indigenous/Native American
Arab
Aboriginal/Austrailian
European
Email
Phone Number
Address
Date of Birth
Place of Employment
90
Job Title
60
How did you hear about us?
Friends
Social Media
Other
Area(s) of Expertise
Accounting/Finance
Event Planning
Record Keeping/Administrative
Web Design/Management
Arts & Crafts
Hospitality
Law/Legal
Public Relations/Marketing/Social Media
Health/Fitness/Nutrition
Mental Health/Wellness/Therapy
Fundraising
Grant Writing
Mentoring
Other
Briefly tell us about yourself.
600
Briefly explain why you are interested in becoming a member of La Femme Noire Collective, Inc.
600
What does "self-care" mean to you?
600
Add a Current Headshot (no sunglasses or hats).
Select a File
Max image size is 25MB
Shirt Size
X-Small
Small
Medium
Large
X-Large
2X-Large
3X-Large
4X-Large
Please read and check all that apply:
I have read the and understand the information in the Prospective Member Guide.
I understand that submitting this application does not guarantee membership.
I understand that, if selected for membership, there is a one-time $100 new member fee due July 7th.
I understand that, if selected for membership, there are annual dues of $150 due September 14th.
I affirm that all the information provided in this application are true.
Your Signature
*
Clear
SUBMIT APPLICATION
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