Request edit access
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 General Meetings are held every 2nd
Tuesday Except for June, July, Nov. and Dec.
6:00 pm - 7:30 pm 
Located at The Loretto, 2nd Floor
1111 W. 39th St, Kansas City, Mo. 64111
Email *
First & Last Name *
Mailing Address *
Phone Number *
Email Address *
Emergency Contact First & Last Name

 *
Emergency contact phone number

 *
Are you a registered voter? *
Required
Transfer Applicant?
Clear selection
Name of NCBW-KC member supporting your application
Employment Status *
Position Title
Highest Education Completed *
Degree & Certificate *
Institute, College or University *
Please tell us about your interest in NCBW-KC *
Please tell us about yourself *
Please describe how you might actively engage yourself in the organization if you were invited to become a member? *
Please check your preferences on Standing Committees *
Please check your preferences on Programs
Clear selection
Please select your availability to have an introductory chat with NCBW-KC.
Clear selection
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 $150 and includes National due of $50 and the Kansas City due of $100.  I will attend general meetings on a regular basis, and I will participate in at least one committee 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 $100 for KC Chapter totaling $150
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. Ask us about our Membership Option Plan.

Check here if you are interested in running for political office or starting your own business
Application Signature
First & last name
 *
Date *
Thank you for completing the application. We are excited to have you in our organization.
Captionless Image
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report

Google Forms