Preview mode
Published
Copy responder link
Request edit access
JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Membership Inquiry
Organizing Black is a grassroots, member-led organization dedicated to fighting for the liberation of all Black people by building local power through transformational Black direct action organizing, political education, and participatory governance practices
* Indicates required question
Email
*
Your email
Full (Given) Name
*
Your answer
Chosen Name
*
Your answer
Phone Number
Your answer
Age
*
18-24
25-34
35-44
45-54
55+
Pronouns
*
Your answer
Do you identify as Black?
*
Yes
No
What is your ethnicity? Check all that apply.
*
Black/African American
African
Latino/a/x
Indigenous
Asian
Pacific Islander
Multiracial
Other
Required
Are you from Baltimore? If not, how long have you lived here?
*
Your answer
How did you learn about Organizing Black?
*
Facebook
Instagram
Twitter
News
Search Engine
Word of mouth
An event hosted by Organizing Black or an event we attended
Other:
Required
Were you referred by an OB member? If yes, who?
Your answer
Why are you interested in becoming a member?
*
Your answer
Do you agree with the following: Organizing Black is a grassroots, member-led organization dedicated to fighting for the liberation of all Black people by building local power through transformational Black direct action organizing, political education, and participatory governance practices.
*
Yes
No
Do you agree with the following: We are practitioners in a world that does not yet exist, therefore we are working for a world where Black lives are no longer systematically targeted for demise. Organizing Black envisions a world where all Black people are free to exist in this world as their full authentic selves. We envision a world where all Black people are economically, politically, and socially free. We envision a world where all Black people are free from chains and cages.
*
Yes
No
Do you believe in abolition?
*
Yes
No
Need more education on it
Do you believe in defunding the police?
Yes
No
Need more education on it
Clear selection
If you were to become a member, would you be able to pay $10/month in dues?
*
Yes
No
If you were to become a member, what skills and/or offerings would you be able to bring to Organizing Black? (examples: organizing, direct action, djaying, photography, dance, cultural practices, transformative justice, mediation, etc)
*
Your answer
If you were to become a member, what skills would you like to develop during your time with Organizing Black?
*
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Organizing Black.
Does this form look suspicious?
Report
Forms
Help and feedback
Contact form owner
Help Forms improve
Report