Membership Application | National Congress of Black Women

National Congress of Black Women- Kansas City Chapter Application Form

Local Purpose: Empower and engage Black women in utilizing their voices in the decision-making process; to develop local solutions to cultural, educational, economic, and political issues that affect Black communities.

NCBW - KC Meetings are held every 2nd

Tuesday Except for June, July, Nov-Dec.

6:00 pm - 7:30 pm Located at CHES, Inc.,

3125 Gillham Plaza, Kansas City, MO 64109

Email(Required)

Name(Required)

First Last

Mailing Address(Required)

Phone Number(Required)

Email Address(Required)

Emergency Contact First & Last Name

First Last

Emergency contact phone number(Required)

Are you a registered voter?(Required)

Yes

Transfer Applicant?(Required)

Yes

If yes, which chapter?

Name of NCBW-KC member supporting your application(Required)

Employment Status(Required)

Active

Retired

Employer

Position Title

Highest Education Completed(Required)

Degree & Certificate(Required)

Institute, College or University(Required)

Please tell us about your interest in NCBW-KC(Required)

Please tell us about yourself(Required)

Please check your preferences on Standing Committees(Required)

Please check your preferences on Programs(Required)

Healthcare Program ( KC)

Workforce Development

College for Kids Program

Voter Registrations & Education

Women Abuse & Domestic Violence

Community Service & Volunteer Program

Women and Girls Torch Carriers Conference

As an active adult member, I will pay the annual membership which includes National and Local dues, and other related costs as specified. The adult membership cost is $125 and includes National due of $50 and the Kansas City due of $75. I will attend meetings on a regular basis and I will participate in committees of my choice and fulfill the duties needed for the success of NCBW-KC. I will actively participate in order that the Chapter accomplishes its missions and goals as stated in the NCBW — Kansas City Bylaws, as well as the National Bylaws.

Please select the desired annual membership category

Adults: Select both $50 for national and $75 for KC Chapter totaling $125

$50 National membership

$10 Youth ( 13-17 years of age)

$25 Young Adult ( 18-25 years of age)

$75 Kansas City Chapter General Membership

I am unable to become a member at this time. Please accept my contribution of $

**NCBW works financially with women regardless of their ability to pay national and local chapter membership dues at this time. Ask us about our Membership Option Plan.

Check here if you are interested in running for political office or starting your own business

Yes, I am interested in running for office.

Application Signature First & last name

Date

Thank you for completing the application. We are excited to have you in our organization.

Your answer